A CCG in east London has claimed it is saving thousands of pounds on moving mental health check-ups into GP practices rather than outpatient clinics.
An evaluation of a scheme in NHS Newham CCG, which sees patients with stable severe mental health illnesses having regular check-ups with community psychiatric nurses (CPNs) in GP practices instead of a hospital psychiatrist, has shown just 10% of patients relapsed and had to return to psychiatric care.
It also found that when they were better they wanted to return to the care of their GP.
Three years after it was first launched, the programme now covers 600 patients who have opted into the scheme, spanning 61 GP practices in NHS Newham CCG which have access to four CPN teams on stand-by.
According to NHS England, the initiative has ‘saved thousands of pounds’ for the CCG, which it has been able to reinvest some of the funding towards new services provided by the East London NHS Foundation Trust.
Initiatives include a ‘buddying’ programme, whereby people who have been through similar experiences but are now better help others return to work.
However, one problem identified was that patients are awarded housing or transport benefits following contact with secondary care, and are thus in danger of losing such benefits. The CCG said it is still having to work through this on a case-by-case basis.
Dr Lise Hertel, an NHS Newham CCG GP representative, said there was initially resistance to the scheme from GPs, practice nurses and psychiatrists but that ‘regular discussions’ had helped resolve issues.
She said: ‘This service achieves appointments that are closer to home and the patients can be seen more often. The GPs and practice nurses can also carry out any physical health checks and start treatment immediately with patients and their carers, not done previously at the outpatient checks at the hospital, including vaccines such as flu, blood pressure monitoring and cardiovascular disease and diabetic checks.
‘The GPs’ QOF scores have increased as a result and this has helped fund the primary care mental health development.’
NHS England national clinical director for mental health Dr Geraldine Strarthdee said: ‘Often outpatient clinics can become incredibly busy seeing relatively stable people, and the capacity to respond to crises to prevent a deterioration or prevent an unnecessary admission is then very limited.
‘Where there is no longer a need for people to visit an outpatient unit, it is better for them to have their appointment in their GP surgery close to home. Not only is it better for the patient, but it also frees up appointments with specialists for those who need more serious interventions.’