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Start small and gain momentum

Dr Tom Debenham's practice saved £400,000 in a year by shifting management of some chronic conditions from secondary to primary care.

Dr Debenham told the Pulse seminar that he and his GP colleagues benefited from an 'invest to save' strategy developed by his PCT.

It gave the practice £30,000 to cover start-up and management costs. This enabled him to establish an integrated nurse and social worker team who came up with ways to shift services out of hospitals.

The practice's hospital admissions are now 15 per cent below average.

Dr Debenham warned GPs that achievements would not happen overnight, but added: 'There are a lot of things you can do if you start at a small level to make a difference and then you get momentum.'

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