Health Secretary announces case management sites
Health Secretary John Reid announced a new programme for chronic disease management at a Birmingham conference last week.
He said that the Government was launching a funded programme to establish “case
management demonstrator sites” within each strategic health authority.
These would “provide co-ordinated patient-centred care within a
whole systems approach to keep patients with the greatest burden of illness
healthy for longer”.
In Britain around 17.5 million people suffer from chronic disease and
the figure is expected to grow. The World Health Organization has estimated
a doubling of chronic disease in the over 65s by 2030.
Dr Reid explained that in “case management”, patients with
complex needs were identified and supported by skilled practitioners
working holistically in an integrated care system. The aim was to provide
alternatives to inpatient hospital care by building capacity and developing
services in primary and community settings.
The demonstrator sites, currently being selected, aimed to achieve the
following:
· Maintain health and promote well being
· Detect early changes in the patient’s condition and prevent unnecessary
hospital admission
· Facilitate safe early discharge, when admissions did occur
· Access ways to identify their target populations
Dr Reid commented that several primary care trusts had already been
encouraged to adopt co-ordinated and integrated services. The American
organisation Kaiser Permanente was partnering a number of PCTs to share
lessons in this type of care, with the focus on managing chronic conditions
to avoid unnecessary hospital admission. Nine PCTs were implementing
the US Evercare model to keep elderly people healthy and offering a range
of services in the community to treat patients in the least intensive
setting.
A pilot of active management at Castlefields Health Centre, Cheshire,
had shown a 15 per cent reduction in admissions for older people and
an average 31 per cent shorter hospital stay (from 6.2 days to 4.3 days).
Although Dr Reid did not mention the place for pharmacy in his plans,
David Pruce, director of practice and quality improvement, Royal Pharmaceutical
Society, told The Journal : “This cannot be done without pharmacy
input. It is all about keeping people out of hospital and helping people
make the most of their medicines. It ties in with concordance and medicines
management.” He emphasised that pharmacy had to be part of the
chronic care solution, adding that the profession had to position itself
as such. |
The
Pharmaceutical Journal