Service redesign needs to target unscheduled care
Commissioners should try to reduce patient contact with hospitals |
Practice-based commissioning offers a great opportunity for community pharmacists to be co-providers of services with GP practices but they need to be proactive, according to Donal Hynes, medical director at Somerset Coast Primary Care Trust and co-vice chairman of NHS Alliance.
“I am afraid that people are standing back and waiting for commissioning
plans to appear. Providers need to approach commissioners with a plan.
The agenda needs to be pushed by innovative and entrepreneurial providers,” he
told The Journal.
Dr Hynes believes that practices which are redesigning services though
practice-based commissioning should, in the first instance, concentrate
on freeing resources by reducing unscheduled admissions rather than focusing
on reducing outpatient appointments.
Speaking at a Department of Health conference entitled “Practice-based
commissioning: achieving universal coverage” in London earlier
this month, Dr Hynes said that the vast majority of money in hospitals
is spent on inpatient care rather than on outpatients. For example, his
local NHS trust spends about £54m per year on inpatient care and
only £6.6m on outpatients. Practices that put a lot of effort into
reducing scheduled outpatient referrals may not benefit from freed resources
because they have not managed to reduce unscheduled care, he said.
Sue Carter, pharmaceutical adviser and locality lead for practice-based
commissioning at Adur, Arun and Worthing Primary Care Trust, told The
Journal that opportunities will exist in this area for proactive groups
of pharmacists. “Pharmacists will need to come up with ‘win-win’ ideas
for enhanced services that will prevent unscheduled admissions to hospital.
For example, up to 8 per cent of patients that attend accident and emergency
departments could have been treated at a pharmacy under a minor ailments
scheme,” she said.
Dr Hynes highlighted that once resources from unscheduled care have been
freed practices can plough the money back into long-term conditions.
Vision p626 |
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