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GPs buried under trusts' workload dump

Reid says US-style care will cut GPs' workload

Health Secretary John Reid claims GPs' workload will be dramatically cut by his plans to roll-out a US-style revolution of chronic disease management across the UK.

Mr Reid described as 'striking' the results of a GP-based pilot of pro-active case management of high-risk chronic disease patients.

Demonstrator sites will be launched this year in each of the 28 strategic health authorities with the aim of proving that active case management can cut emergency hospital admissions and reduce GP consultation rates.

Mr Reid, who unveiled his plans at a conference last week, said the pilot at Castlefields health centre in Runcorn, Cheshire, achieved a 15 per cent reduction in hospital admissions for elderly patients.

Dr David Lyon, a GP at the centre, told Pulse there had

also been a 15 per cent fall in GP home visits to patients over 65 in the first year of the project.

The pilot uses a social care worker and specialist nurses to target the highest-risk patients for active preventive care.

Mr Reid said a 'radical' shift towards more proactive care was essential if the NHS was to meet the 'huge challenge' of spiralling chronic disease rates.

He said up to 80 per cent of GP consultations were by patients with chronic diseases and the introduction of specialist case workers – usually nurses – would cut GPs' work.

The drive is modelled on US health management organisations Evercare and Kaiser Permanente, who are piloting their methods in the NHS.

Mr Reid revealed that the first data to emerge from the Evercare pilots in nine PCTs show just 2 per cent of high-risk over-65s account for 30 per cent of all emergency admissions in that age group. Many admissions were for preventable problems such as UTIs and dehydration.

But Dr Harry Yoxall, LMC medical secretary in Somerset – where one of the Kaiser pilots is operating – said : 'These pilots are in the planning stage or only just started. It's too early to launch yet another initiative.'

GPC negotiator Dr Ham-ish Meldrum said the Government should give the new GMS contract a chance to improve chronic disease care before turning to US models.

By Joe Lepper and Emma Wilkinson

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