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Case study: Delivering services to intermediate care patients

Dr Ian Pawson explains how his practice provides primary care services to intermediate care patients, which he believes can provide practices with an opportunity to both expand and improve patient care.

Dr Ian Pawson

At the RCGP annual conference in Harrogate this month, Dr Ian Pawson, a GP partner at Brownlow Heath in Liverpool, presented a poster explaining how his practice has expanded the services it provides through working with intermediate care sites. He talks about the scheme in the video below.

Our large inner city practice has been involved in providing GP cover to intermediate care for a number of years. We use a proactive model of care at these sites, by visiting each site three times a week, believing that this pre-empts medical problems from escalating thereby reducing re-admission rates, and improving confidence and communication between care staff and the medical team.

Commissioners recognised our high quality service and we were approached to expand our service in early 2015. Our service now covers 100 in-patient intermediate care beds across four sites (previously 45 in early 2015), and has in excess of 45-50 patients admitted per month.

We recognised expansion as an opportunity to innovate, introducing a pharmacist and prescribing clerks/administrative support to our team, as well as introducing new pathways and remote technology.

Patient outcomes

These changes have contributed to excellent outcomes throughout significant service expansion, including:

  • Significant improvement in number of patients having admission letters sent out to GP (52% to 92%)
  • Improved number of pharmacist-led medication reviews on admission (37% to 96%)
  • Maintaining high standards of record keeping for risk areas such as transmission of prescriptions between practice and pharmacy

Employing new ways of working by recognising opportunities to provide new or expanded services is crucial in the current primary care climate. It also brings benefits such as opportunity for funded services outside of the core contract and funding for new staff who can improve quality and efficiency of care for the whole practice team through a widened skill mix.

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