Earlier this month I explained why the Government has asked our clinical commissioning group to ‘ring-fence’ some of our budget for helping Doncaster’s GP practices to develop new ways of improving services for vulnerable people.
Vulnerable people are usually those in need of community services due to age, illness or a mental or physical disability. We have allocated £3 million over the next two years to fund new ways of improving health services for these patients, who are frequently in contact with the NHS, often in an emergency.
Doncaster’s 43 GP practices put forward over 40 improvement schemes which are approved for funding. Here’s a flavour of what some will be doing.
In south east Doncaster, practices in Armthorpe, Auckley, Bawtry, Tickhill, Rossington and town centre will work together to actively manage their most vulnerable patients, including checking on their social wellbeing as well as their health needs. Practice staff will use new technology – like Skype and Facetime – to get clinical advice from GP colleagues when visiting patients.
The Burns Practice, with surgeries at Bennetthorpe and Cantley, will recruit a health worker to provide a care management service to vulnerable patients and their families. They will keep a special eye on those who have complex health needs, or who are socially isolated, to help them keep well.
The Hatfield Practice is focusing on its nursing and residential home patients. The practice has over 160 patients living in the six homes it covers who have challenging health needs. Such patients need to be monitored closely as their health can quickly deteriorate, often resulting in emergency visits to hospital. The practice plans to introduce a weekly ward round of patients at each nursing or residential home by a named doctor, who will also give advice to the home’s care staff. This will help reduce the need for visits to A&E and improve patient care.
Stainforth’s Field Road Surgery is planning a similar approach of regular ward rounds for its patients who live in local nursing and residential homes.
The Scott Practice and St John’s Group Practice, both in Balby, will try to cut the number of emergency hospital admissions made by their older patients. The practices will jointly employ a community nurse who has the dedicated task of caring for vulnerable people and those nearing the end of their life.
And Kingthorne Practice, where I work, is introducing new ‘multi-disciplinary’ meetings, involving a range of health workers, to co-ordinate the care of our most vulnerable patients. We will also work closely with a care of the elderly consultant to help care for patients with very complex needs.
I’m looking forward to seeing real health benefits for our most at-risk patients as these innovative schemes get under way very soon. We’ll be assessing them closely to see which we can take forward in the long term.
* Dr Nick Tupper, Chairman, Doncaster clinical commissioning group