Evaluating the Primary Care Home programme

April 13, 2017

Thousands of patients benefit from the National Association of Primary Care's Primary Care Home programme as a new report shows a drop in emergency hospital admissions and waiting times for GP appointments.

The Primary Care Home programme is delivering a range of benefits for patients, staff and the wider health system, according to the new report. Key findings from an early analysis of three rapid test sites show significant reductions in A&E attendances, emergency hospital admissions and GP referrals to hospital.

For GP practices and other providers involved, the benefits include reduced prescribing costs and a rise in staff satisfaction and retention. Patients have experienced a drop in the average waiting time to see their GPs and reduced stays in hospital.

The model brings together a range of health and social care professionals – from GP surgeries, community, mental health and acute trusts, social care and the voluntary sector – to focus on local health priorities and provide out of hospital care closer to patients' homes.

Commissioned by the National Association of Primary Care (NAPC), the report Does the Primary Care Home Make a Difference? looked at the impact of three Primary Care Home (PCH) rapid test sites, covering a population of more than 110,000, and assessed how the programme could support the delivery of the 44 Sustainability and Transformation Plans (STPs) across England.

The report by PA Consulting Group concludes that the Primary Care Home programme can unlock a range of financial and non-financial benefits. It says, 'Implementing the PCH ways of working can drive positive change in a relatively short period of time. This points to the fact that the defining characteristics of the PCH make it a vehicle for change, and that it is a catalyst enabling faster progress to be made in addressing local primary care priorities.'

The report found the model could support the delivery of STPs and the triple aims of health and wellbeing, care and quality, and financial efficiency as set out in the Five Year Forward View. With staff key to their success, it highlighted that PCH could engage them to own their futures, achieve a happier workforce with reduced sickness and increased retention, and foster a sense of partnership and collaboration. It says, 'The launch of the PCH is timely. The morale across primary care is decreasing. What is required now is a scalable model that is easy to introduce, that unlocks the creativity and energy of staff with the aim of making rapid improvements in the way that primary care is delivered.'

Developed by the NAPC, Primary Care Home offers an innovative approach to strengthening and redesigning primary care to support the delivery of the Five Year Forward View – the shared vision for the NHS. CMM covered the Primary Care Home programme in its Business Clinic Primary Care Home Model - is it the answer?

Following the success of 15 rapid test sites, PCH has been rolled out to another 77 sites to develop and test the model (referred to as the community of practice, a learning network), bringing the total number to 92. More than 50 sites have applied to be part of the third wave, which would bring the number of patients covered by PCH to between five and six million.

Some benefits from the three rapid test sites are outlined below.

The creation of an Acute Response Team at Thanet Health in Kent led to a sharp fall in A&E admissions. The team – made up a GP, nurses, health care assistants, physiotherapist, occupational therapist, voluntary care, care agency working closely with social services – provides a range of treatment and personal care support to keep people – particularly the frail elderly – out of hospital. They assess patients and put a package of care in place to enable them to remain at home or be discharged. Over a 10-week trial period in 2016/17, admissions fell by 155 compared to the same period last year, suggesting potential annual savings of almost £300,000

Larwood and Bawtry in Nottinghamshire cut prescribing costs by 5% following the appointment of a practice pharmacist who carried out medicine reviews for care home residents. Analysis over a seven-month period found a significant reduction in prescribing costs and projected £229,000 annual savings, as well as reducing the risk of side-effects for patients.

The Beacon Medical Group in Plymouth cut the average waiting time to see a GP by six days by redesigning its Urgent Care Team and extending it to include another 7,000 patients. The team has an additional two nurse practitioners and paramedic as well as GPs and pharmacists. The Group ensures people seeking an urgent appointment are seen quickly by one of their specialist staff, rather than having to wait to see a doctor. Over six months, the average waiting time for a GP appointment fell from 14 to eight days.

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