Exclusive The cost of treating ‘high impact' COPD patients in some PCTs is more than double that in other parts of the country, with dramatic variation in the rate of emergency hospital admissions, new commissioning data obtained by Pulse reveals.
The statistics, compiled by Dr Foster Intelligence and published on an interactive map on PulseToday this week, reveal the stark differences in COPD spending across England and identify millions of pounds in potential savings for GP commissioners as they prepare to assume budgetary responsibility. Click here to see a map of the data.
Dr Foster looked at data from 8,469 GP practices across England in 2010, and standardised rates of admissions to account for factors such as age, sex and deprivation, which enabled an expected number of non-elective COPD admissions to be calculated based on national rates.
Some 1,036 practices were identified as having a ‘significantly high' proportion of admissions, with this accounting for more than half of those in NHS Rotherham and NHS Ashton, Leigh and Wigan.
NHS Manchester was singled out as the area with the most to gain from controlling above-average admission rates, with potential savings topping £1.6 million. The potential savings were NHS Liverpool, NHS Leeds and NHS Rotherham could all make savings of more than £1 million.
The average cost of a high impact user – a COPD patient who has had three or more emergency admissions for any diagnosis in the past 12 months – ranged from £3,226 in Solihull to more than £6,000 in inner-city areas such as Camden and Lewisham.
Dr Peter Weaving, a GP in Brampton, Cumbria and joint chair of NHS Cumbria's Clinical Senate, said: ‘It's a massive problem in terms of emergency admissions for us – incidence of COPD here is one in 50.'
Cumbrian GPs were keen to treat patients in the community where possible, he said. But he added: ‘Equally we recognise research shows patients with COPD actually prefer to be admitted to hospital for acute care rather than getting palliative treatment for their conditions.'
Dr Amir Hannan, a GP in Hyde, Greater Manchester, said that his practice had provided acess to medical records for 15% of COPD patients as a means of encouraging self-care.
He said: ‘The answer does not lie in us as GPs doing more, with potentially less and less resources, but rather enabling patients and carers to do more for themselves by providing more information.'