Keeping patients out of hospital lies at the heart of Central Lancashire healthcare plans

GP referrals to A&E could be cut by up to 15 percent
GP referrals to A&E could be cut by up to 15 percent
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A group of Central Lancashire GPs has backed a blueprint for the future of the NHS in the area.

The so-called ‘model of care’ laid out a vision for how health services in the region should operate – but offered fewer specifics than a draft version of the document which emerged last summer.

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That report had put forward the possibility of a single Accident and Emergency unit in Central Lancashire and the continued operation of two urgent care centres – but did not suggest where any of the facilities should be located.

It also floated the idea of a ring-fenced site for pre-planned procedures to reduce the risk of operations being cancelled as a result of bed pressures on the emergency side of the system. That option was restated in the latest version of the plan, which was unanimously approved at a joint committee of the Greater Preston and Chorley and South Ribble Clinical Commissioning Groups (CCGs).

But the new report gives no indication of how many individual A&E and urgent care facilities may ultimately be proposed - nor where they would be based.

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The sustainability of acute services was the focus of the proposed model, but papers presented to the meeting stated that the challenges facing Central Lancashire’s hospitals “do not start at their front door” – and stressed the need for better prevention.

However, members heard that change was required to better integrate different aspects of patient care and make the system work more effectively.

Among the proposals was a plan for a virtual advice hub, where senior hospital clinicians would help colleagues in primary or community care decide the best route for a patient to take in order to obtain treatment. The meeting was told that process could reduce the number of people attending hospital after a direct referral from their GP by up to 15 percent.

Meanwhile, urgent care care services could be reshaped to “go further” than national guidelines by being staffed at the busiest times with “senior decision-makers” from the hospital sector, as well as the GPs more usually associated with such facilities.

The ultimate aim of any change would be to keep all but the sickest patients out of the hospital environment and allow those with more minor complaints to be treated closer to home.

Dr. Geraldine Skailes, medical director for trust which runs the Royal Preston and Chorley and South Ribble hospitals said that the current system “cannot continue to meet the demands [placed upon it], even if we become as efficient as we possibly can”

“Structural change” would be required, Dr. Skailes added.

More detailed options will now be developed about how the new model could be put into practice. If the final proposals were to result in significant change to the way services are currently delivered, a formal public consultation would have to take place.

That process had been planned for earlier this year, but was put on hold until after May’s local elections – and no new date has since been set.

Any suggested changes would have to be assessed by NHS England before being put to the public.

OUTPATIENT OVERHAUL

Plans to avoid “unnecessary hospital appointments” were also outlined in the vision to redesign NHS services in Central Lancashire.

Suggestions include more effective use of community services to provide care to patients in their own home once they have been discharged from hospital – and prevent them having to return for check-ups.

Increased use of technology could see “remote monitoring” of data relating to patient health – like blood pressure – to alert medics to any problems. Clinical intervention would be “triggered by patient need”, rather than as a matter of routine.

Telephone and video consultations, which are increasingly commonplace, could also be expanded. However, CCG chair Dr. Sumantra Mukerji, warned that care would have to be taken not to “disadvantage” any patients who were unfamiliar with the technology.