This document provides information about an NHS top-up insurance plan offered by Western Provident Association Limited (WPA) including details on benefits, premiums, and exclusions. Key points include:
- The plan provides reimbursement for everyday healthcare costs like dental, optical, therapies and more.
- It also includes an employee assistance program (EAP) with counselling and other services.
- Premiums start at less than £1 per week per employee.
- Benefits are provided at three different reimbursement levels.
- Additional benefits like health screens, cancer drugs coverage and European travel coverage can be added.
- Exclusions include chronic conditions, childbirth/fertility, and psychiatric conditions
This document summarizes mobile medicine strategies and a vision for providing unscheduled medical services for all providers. It discusses the current state of unscheduled care including overuse of emergency medical services for non-emergent issues. It then outlines a new world with opportunities for partnerships and new payment models emphasizing quality outcomes. Specific strategies proposed include nurse triage of 911 calls, community health programs, reducing heart failure readmissions, avoiding observation admissions, and reducing hospice revocations. Financial analyses are provided estimating cost savings from avoiding transports, ED visits, admissions and other services. Patient and provider satisfaction opportunities are also discussed.
This document summarizes a webinar presented by Kennen Gross on hospital claims data. It discusses what hospital claims data is, why it is needed, how to obtain it, and what can be done with it once obtained. Specifically, claims data can be used to understand health problems in a population, develop interventions to address those problems, and evaluate the impact of solutions by analyzing costs, utilization rates, diagnoses, and individual patient profiles over time.
1) The document discusses the cost-effectiveness of drug-eluting stents (DES) compared to bare-metal stents (BMS) based on clinical trial data from 2003 and 2009.
2) While practice patterns have changed, DES remain cost-effective compared to BMS for patients with a predicted BMS target vessel revascularization rate of over 10-11%.
3) The most promising ways to further improve the cost-effectiveness of DES are to reduce stent thrombosis risks or decrease the duration of mandatory dual antiplatelet therapy.
The VA Home Based Primary Care (HBPC) program provides comprehensive primary care to veterans in their homes through an interdisciplinary team approach. It serves veterans who are too ill to access regular clinic-based care and has grown significantly since 2000. Studies show HBPC reduces hospitalizations, nursing home stays, and costs of care while improving quality of life for veterans and their caregivers compared to usual care. HBPC may also reduce total costs for the VA and Medicare combined through lower utilization. Veterans report that the personalized care of HBPC helps them avoid emergency room visits and improves their daily lives.
The document outlines a 6-month training plan for various groups on topics related to caring for people living with HIV/AIDS (PLWHA) and orphans and vulnerable children (OVC) in Vietnam. It includes 28 training courses that will be provided to home-based care teams, Friend-Help-Friend groups, PLWHA and families, peer propagandists, women's union members, and primary school teachers. The trainings will cover subjects like symptom recognition, home-based care skills, nutrition, antiretroviral treatment, stigma reduction, psychology, and life skills. The plan estimates over 100 million VND will be spent to train over 500 participants total across the different groups and locations during the
The document outlines a 6-month training plan for various groups on topics related to caring for people living with HIV/AIDS (PLWHA) and orphans and vulnerable children (OVC) in Vietnam. It includes 28 training courses that will be provided to home-based care teams, Friend-Help-Friend groups, PLWHA and families, peer propagandists, women's union members, and primary school teachers. The trainings will cover subjects such as symptom recognition, home-based care skills, nutrition, antiretroviral treatment, stigma reduction, psychology, law, and life skills. An estimated total cost of 100,320,000 Vietnamese Dong is provided for the training plan.
The document discusses Tiltti, a Finnish project that provides peer support and information for problem gamblers. It was started in 2010 and is funded by RAY. Tiltti is part of the Finnish Blue Ribbon organization and provides individual counseling, treatment referrals, group support activities, and an open door walk-in space. Tiltti also collaborates with the Gambling Clinic to provide specialized treatment and peer support groups for those who have not engaged with other services or are at risk of dropping out of treatment. One such group is the Tuesday group, designed for people who want to quit gambling but find it difficult to start a formal therapy process.
This document provides information about an NHS top-up insurance plan offered by Western Provident Association Limited (WPA) including details on benefits, premiums, and exclusions. Key points include:
- The plan provides reimbursement for everyday healthcare costs like dental, optical, therapies and more.
- It also includes an employee assistance program (EAP) with counselling and other services.
- Premiums start at less than £1 per week per employee.
- Benefits are provided at three different reimbursement levels.
- Additional benefits like health screens, cancer drugs coverage and European travel coverage can be added.
- Exclusions include chronic conditions, childbirth/fertility, and psychiatric conditions
This document summarizes mobile medicine strategies and a vision for providing unscheduled medical services for all providers. It discusses the current state of unscheduled care including overuse of emergency medical services for non-emergent issues. It then outlines a new world with opportunities for partnerships and new payment models emphasizing quality outcomes. Specific strategies proposed include nurse triage of 911 calls, community health programs, reducing heart failure readmissions, avoiding observation admissions, and reducing hospice revocations. Financial analyses are provided estimating cost savings from avoiding transports, ED visits, admissions and other services. Patient and provider satisfaction opportunities are also discussed.
This document summarizes a webinar presented by Kennen Gross on hospital claims data. It discusses what hospital claims data is, why it is needed, how to obtain it, and what can be done with it once obtained. Specifically, claims data can be used to understand health problems in a population, develop interventions to address those problems, and evaluate the impact of solutions by analyzing costs, utilization rates, diagnoses, and individual patient profiles over time.
1) The document discusses the cost-effectiveness of drug-eluting stents (DES) compared to bare-metal stents (BMS) based on clinical trial data from 2003 and 2009.
2) While practice patterns have changed, DES remain cost-effective compared to BMS for patients with a predicted BMS target vessel revascularization rate of over 10-11%.
3) The most promising ways to further improve the cost-effectiveness of DES are to reduce stent thrombosis risks or decrease the duration of mandatory dual antiplatelet therapy.
The VA Home Based Primary Care (HBPC) program provides comprehensive primary care to veterans in their homes through an interdisciplinary team approach. It serves veterans who are too ill to access regular clinic-based care and has grown significantly since 2000. Studies show HBPC reduces hospitalizations, nursing home stays, and costs of care while improving quality of life for veterans and their caregivers compared to usual care. HBPC may also reduce total costs for the VA and Medicare combined through lower utilization. Veterans report that the personalized care of HBPC helps them avoid emergency room visits and improves their daily lives.
The document outlines a 6-month training plan for various groups on topics related to caring for people living with HIV/AIDS (PLWHA) and orphans and vulnerable children (OVC) in Vietnam. It includes 28 training courses that will be provided to home-based care teams, Friend-Help-Friend groups, PLWHA and families, peer propagandists, women's union members, and primary school teachers. The trainings will cover subjects like symptom recognition, home-based care skills, nutrition, antiretroviral treatment, stigma reduction, psychology, and life skills. The plan estimates over 100 million VND will be spent to train over 500 participants total across the different groups and locations during the
The document outlines a 6-month training plan for various groups on topics related to caring for people living with HIV/AIDS (PLWHA) and orphans and vulnerable children (OVC) in Vietnam. It includes 28 training courses that will be provided to home-based care teams, Friend-Help-Friend groups, PLWHA and families, peer propagandists, women's union members, and primary school teachers. The trainings will cover subjects such as symptom recognition, home-based care skills, nutrition, antiretroviral treatment, stigma reduction, psychology, law, and life skills. An estimated total cost of 100,320,000 Vietnamese Dong is provided for the training plan.
The document discusses Tiltti, a Finnish project that provides peer support and information for problem gamblers. It was started in 2010 and is funded by RAY. Tiltti is part of the Finnish Blue Ribbon organization and provides individual counseling, treatment referrals, group support activities, and an open door walk-in space. Tiltti also collaborates with the Gambling Clinic to provide specialized treatment and peer support groups for those who have not engaged with other services or are at risk of dropping out of treatment. One such group is the Tuesday group, designed for people who want to quit gambling but find it difficult to start a formal therapy process.
The document outlines a presentation given at the 2nd National Primary Care Conference on better outcomes with scarce resources through primary care. It discusses the case for primary care and delivery solutions using total quality management approaches including mechanisms, methods and case studies from the UK of increasing practice capacity and delivering cardiovascular risk assessments through general practices. Examples are provided of monitoring and improving various clinical areas and outcomes.
Daniel Elkeles: Making the business case for integrated workingThe King's Fund
Daniel Elkeles, Director of Strategy, NHS North West London, discusses how to write a business case for integrated care in the current financial climate.
Daniel Elkeles: Integrated care in North West LondonNuffield Trust
The document describes integrated care efforts in North West London led by the Integrated Care Pilot (ICP). It summarizes barriers overcome like aligned incentives, joint governance, and information sharing. It outlines the pilot's goals of improving outcomes, reducing costs through better coordinated care across providers. It details how practices were organized into 10 multi-disciplinary groups to provide coordinated care for over 550,000 patients, and how the pilot has begun showing reductions in emergency admissions and A&E attendances.
Breakout 2.4 Making the system work for you:Using levers and drivers to deliv...NHS Improvement
Breakout 2.4 Making the system work for you:Using levers and drivers to deliver change
Lesley Kitchen Advancing Quality, Programme Director
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 4.2 Optimise not maximise for better value COPD and asthma care - No...NHS Improvement
Breakout 4.2 Optimise not maximise for better value COPD and asthma care - Noel Baxter
Co-lead NHS London Respiratory Team
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
John Ribchester: Community integrated health careNuffield Trust
Whitstable Medical Practice has developed a model of community integrated healthcare to address the growing health needs of its aging population. The practice has expanded services to include diagnostics, outpatient clinics, therapies, screening, and minor procedures delivered on site or through partnerships. This has resulted in cost savings up to 63% compared to traditional referrals, shorter wait times, and improved patient experience. The practice has also strengthened partnerships to coordinate long-term condition management, urgent care, and rehabilitation services. While this model has benefits, expanding it would require overcoming obstacles such as practice consolidation, facility upgrades, and gaining support from clinical commissioning groups and other stakeholders.
STAHCOM LTD is a Primary Care Trust (PCT) that aims to enhance primary care services for patients in St Albans and Harpenden. It has several objectives, including improving quality of care, providing a greater range of services closer to home, and monitoring long-term conditions. The PCT is led by a Chief Executive and Board of Directors. It oversees various working groups and has policies in place. STAHCOM has received approval to take on additional commissioning responsibilities at Level 3, such as for clinical assessment and treatment services. It aims to shift appropriate care from secondary to primary settings. The PCT has made progress but also faces barriers from delays in decision making and lack of data and support from
Evaluating health and social care interventions in a CCG - Jo BroadbentIan Brown
This document summarizes two case studies evaluating health and social care interventions in a clinical commissioning group (CCG) in the UK. The first case study found that expanding early supported discharge (ESD) services for stroke patients reduced social care packages by 57% and saved an estimated £172k-£572k per year. The second case study evaluated "virtual wards", which used multidisciplinary case management in the community, and found a 19% reduction in avoidable hospital admissions and increased integration between health and social care services. The document discusses challenges with evaluation including data limitations and managing expectations of decision-makers.
Dr Derek Thompson: Building a caring futureNuffield Trust
In this slideshow, Dr Derek Thompson, GP and Medical Director at Northumbria Healthcare Foundation Trust, on reducing the length of hospital stay and building a caring future.
Dr Thompson spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September2014.
Quality, Innovation, Productivity and Prevention in Primary CareNHSScotlandEvent
What do the Quality Ambitions mean for Primary Care? This session describes the ongoing innovative local improvements and national work with NHS
Boards and Primary Care contractors to improve quality, efficiency and outcomes as well as the future plans for Primary Care.
This document summarizes a presentation given at the Primary Care Conference on livinghealth on November 17th, 2011 by Dr. David Molony. The presentation discussed innovation, research, and standards in primary care as well as barriers to development. Specific examples were given of an innovative warfarin clinic, a research study on ear health in the elderly, and developing standards for primary healthcare centers. Barriers to primary care development mentioned included a lack of flexibility and proper commitment of resources from hospitals. The presentation argued that primary care can provide many services more efficiently than hospitals and help address issues of cost and wait times if given more support and flexibility.
Five priorities for care of the dying personMarie Curie
Dr Bill Noble, Medical Director of Marie Curie Cancer Care, speaks at the end of life sesion with Dr Adam Firth (RCGP Clinical Support Fellow for End of Life Care).
This session was chaired by Dr Peter Nightingale, Marie Curie and RCGP End of life lead at the RCGP Annual Conference, ACC Liverpool, 2-4 October, 2014.
For more information visit: mariecurie.org.uk/rcgp
What can the voluntary sector contribute? - Jeremy Taylor, presented at Age UKs "Living well with long term conditions" conference on 14th November 2012
Active signposting. Training reception staff and providing tailored information about services, to connect patients with the most appropriate source of help and advice. Featuring West Wakefield's approach. David Cowan. Social Prescribing & Care Navigation Lead , West Wakefield Health & Wellbeing.
Can integration reduce hospital admissions 2RICHARD YOUNG
This document discusses the results of an integrated care programme in Enfield that aimed to reduce hospital admissions. It found that in the first quarter of full implementation, there was an 8% drop in unplanned admissions for over-65s and a 9% reduction in delayed transfers. However, unplanned admissions rose in other age groups. While clinical outcomes improved and patient satisfaction increased, the economic return has been marginal. The document argues that further transformation, such as harnessing innovation, continued integration of care budgets, and technologies to keep people well, will be needed to successfully reduce costs while improving care.
The future of market access – the local picture PM Society
David Thorne, CEO of Newcastle West CCG, discussed the challenges and opportunities for clinical commissioning groups in shaping local healthcare. He outlined the CCG's responsibilities to identify local health needs, meet national priorities, commission services through performance-managed contracts, and maintain budgets and public confidence in the NHS. Thorne also described Newcastle West CCG's population as aging with high dependency on benefits and life expectancies comparable to developing nations. Key health issues included cancers, heart disease, and COPD. The presentation emphasized using local data and engaging with patients, providers and other stakeholders to design effective local care pathways.
The document discusses efforts in Camden, New Jersey to reduce healthcare costs and improve quality by addressing the needs of high utilizers of emergency departments and hospitals. It describes how a coalition of healthcare providers formed to share data on patient utilization patterns and coordinate care for high-risk patients through a citywide care management program. This program aims to reduce hospitalizations and readmissions by providing intensive care coordination and addressing patients' medical and social needs.
Hugh Reeve: How is the NHS in Cumbria adapting to lessons from the Alternativ...The King's Fund
Hugh Reeve draws on the lessons that can be learnt from the Alternative Quality Contract and shares how Cumbria Clinical Commissioning Group have started to put those lessons into practice.
Parallel Session 2.6 (Re)Connecting with Meaning and MotivationNHSScotlandEvent
The document discusses using a Cost Consequence Analysis (CCA) approach to model and evaluate the impacts of potential changes. It provides examples of how CCA is being used nationally to analyze interventions like falls bundles and anticipatory care planning. It also offers guidance on applying CCA in practice, including developing scenario models to quantify the patient benefits, resource requirements, costs, and cost savings of new interventions. Challenges in using CCA are acknowledged.
The document discusses the increasing prominence of integrated care in health policy documents over time, with references to integration increasing at a rate of 78% per year. While integration is increasingly emphasized, there is no national data showing whether it is actually improving quality of care experienced by individuals. To make integrated care more than just a "pipe dream", the document argues that interventions to support integration must address issues of context, like funding and work stress, through approaches that bring together data, workforce capability, and management across services.
This document summarizes a debate about the role of the voluntary sector in health and social care. It discusses how the voluntary sector can help move towards a new era of partnership between health and social care. While integrating health and social care seems logical, cultural and structural barriers have prevented it from happening. The voluntary sector is well-positioned to play a big role because charities consider the whole person and all their needs, not just medical issues. The document also examines specific areas where more work is needed, such as how the health service can better partner with charities, how charities can save the health service money through prevention and addressing social determinants of health, and how charities can influence and create systems change within health care
The document outlines a presentation given at the 2nd National Primary Care Conference on better outcomes with scarce resources through primary care. It discusses the case for primary care and delivery solutions using total quality management approaches including mechanisms, methods and case studies from the UK of increasing practice capacity and delivering cardiovascular risk assessments through general practices. Examples are provided of monitoring and improving various clinical areas and outcomes.
Daniel Elkeles: Making the business case for integrated workingThe King's Fund
Daniel Elkeles, Director of Strategy, NHS North West London, discusses how to write a business case for integrated care in the current financial climate.
Daniel Elkeles: Integrated care in North West LondonNuffield Trust
The document describes integrated care efforts in North West London led by the Integrated Care Pilot (ICP). It summarizes barriers overcome like aligned incentives, joint governance, and information sharing. It outlines the pilot's goals of improving outcomes, reducing costs through better coordinated care across providers. It details how practices were organized into 10 multi-disciplinary groups to provide coordinated care for over 550,000 patients, and how the pilot has begun showing reductions in emergency admissions and A&E attendances.
Breakout 2.4 Making the system work for you:Using levers and drivers to deliv...NHS Improvement
Breakout 2.4 Making the system work for you:Using levers and drivers to deliver change
Lesley Kitchen Advancing Quality, Programme Director
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 4.2 Optimise not maximise for better value COPD and asthma care - No...NHS Improvement
Breakout 4.2 Optimise not maximise for better value COPD and asthma care - Noel Baxter
Co-lead NHS London Respiratory Team
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
John Ribchester: Community integrated health careNuffield Trust
Whitstable Medical Practice has developed a model of community integrated healthcare to address the growing health needs of its aging population. The practice has expanded services to include diagnostics, outpatient clinics, therapies, screening, and minor procedures delivered on site or through partnerships. This has resulted in cost savings up to 63% compared to traditional referrals, shorter wait times, and improved patient experience. The practice has also strengthened partnerships to coordinate long-term condition management, urgent care, and rehabilitation services. While this model has benefits, expanding it would require overcoming obstacles such as practice consolidation, facility upgrades, and gaining support from clinical commissioning groups and other stakeholders.
STAHCOM LTD is a Primary Care Trust (PCT) that aims to enhance primary care services for patients in St Albans and Harpenden. It has several objectives, including improving quality of care, providing a greater range of services closer to home, and monitoring long-term conditions. The PCT is led by a Chief Executive and Board of Directors. It oversees various working groups and has policies in place. STAHCOM has received approval to take on additional commissioning responsibilities at Level 3, such as for clinical assessment and treatment services. It aims to shift appropriate care from secondary to primary settings. The PCT has made progress but also faces barriers from delays in decision making and lack of data and support from
Evaluating health and social care interventions in a CCG - Jo BroadbentIan Brown
This document summarizes two case studies evaluating health and social care interventions in a clinical commissioning group (CCG) in the UK. The first case study found that expanding early supported discharge (ESD) services for stroke patients reduced social care packages by 57% and saved an estimated £172k-£572k per year. The second case study evaluated "virtual wards", which used multidisciplinary case management in the community, and found a 19% reduction in avoidable hospital admissions and increased integration between health and social care services. The document discusses challenges with evaluation including data limitations and managing expectations of decision-makers.
Dr Derek Thompson: Building a caring futureNuffield Trust
In this slideshow, Dr Derek Thompson, GP and Medical Director at Northumbria Healthcare Foundation Trust, on reducing the length of hospital stay and building a caring future.
Dr Thompson spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September2014.
Quality, Innovation, Productivity and Prevention in Primary CareNHSScotlandEvent
What do the Quality Ambitions mean for Primary Care? This session describes the ongoing innovative local improvements and national work with NHS
Boards and Primary Care contractors to improve quality, efficiency and outcomes as well as the future plans for Primary Care.
This document summarizes a presentation given at the Primary Care Conference on livinghealth on November 17th, 2011 by Dr. David Molony. The presentation discussed innovation, research, and standards in primary care as well as barriers to development. Specific examples were given of an innovative warfarin clinic, a research study on ear health in the elderly, and developing standards for primary healthcare centers. Barriers to primary care development mentioned included a lack of flexibility and proper commitment of resources from hospitals. The presentation argued that primary care can provide many services more efficiently than hospitals and help address issues of cost and wait times if given more support and flexibility.
Five priorities for care of the dying personMarie Curie
Dr Bill Noble, Medical Director of Marie Curie Cancer Care, speaks at the end of life sesion with Dr Adam Firth (RCGP Clinical Support Fellow for End of Life Care).
This session was chaired by Dr Peter Nightingale, Marie Curie and RCGP End of life lead at the RCGP Annual Conference, ACC Liverpool, 2-4 October, 2014.
For more information visit: mariecurie.org.uk/rcgp
What can the voluntary sector contribute? - Jeremy Taylor, presented at Age UKs "Living well with long term conditions" conference on 14th November 2012
Active signposting. Training reception staff and providing tailored information about services, to connect patients with the most appropriate source of help and advice. Featuring West Wakefield's approach. David Cowan. Social Prescribing & Care Navigation Lead , West Wakefield Health & Wellbeing.
Can integration reduce hospital admissions 2RICHARD YOUNG
This document discusses the results of an integrated care programme in Enfield that aimed to reduce hospital admissions. It found that in the first quarter of full implementation, there was an 8% drop in unplanned admissions for over-65s and a 9% reduction in delayed transfers. However, unplanned admissions rose in other age groups. While clinical outcomes improved and patient satisfaction increased, the economic return has been marginal. The document argues that further transformation, such as harnessing innovation, continued integration of care budgets, and technologies to keep people well, will be needed to successfully reduce costs while improving care.
The future of market access – the local picture PM Society
David Thorne, CEO of Newcastle West CCG, discussed the challenges and opportunities for clinical commissioning groups in shaping local healthcare. He outlined the CCG's responsibilities to identify local health needs, meet national priorities, commission services through performance-managed contracts, and maintain budgets and public confidence in the NHS. Thorne also described Newcastle West CCG's population as aging with high dependency on benefits and life expectancies comparable to developing nations. Key health issues included cancers, heart disease, and COPD. The presentation emphasized using local data and engaging with patients, providers and other stakeholders to design effective local care pathways.
The document discusses efforts in Camden, New Jersey to reduce healthcare costs and improve quality by addressing the needs of high utilizers of emergency departments and hospitals. It describes how a coalition of healthcare providers formed to share data on patient utilization patterns and coordinate care for high-risk patients through a citywide care management program. This program aims to reduce hospitalizations and readmissions by providing intensive care coordination and addressing patients' medical and social needs.
Hugh Reeve: How is the NHS in Cumbria adapting to lessons from the Alternativ...The King's Fund
Hugh Reeve draws on the lessons that can be learnt from the Alternative Quality Contract and shares how Cumbria Clinical Commissioning Group have started to put those lessons into practice.
Parallel Session 2.6 (Re)Connecting with Meaning and MotivationNHSScotlandEvent
The document discusses using a Cost Consequence Analysis (CCA) approach to model and evaluate the impacts of potential changes. It provides examples of how CCA is being used nationally to analyze interventions like falls bundles and anticipatory care planning. It also offers guidance on applying CCA in practice, including developing scenario models to quantify the patient benefits, resource requirements, costs, and cost savings of new interventions. Challenges in using CCA are acknowledged.
Similar to Reducing demand for health services (20)
The document discusses the increasing prominence of integrated care in health policy documents over time, with references to integration increasing at a rate of 78% per year. While integration is increasingly emphasized, there is no national data showing whether it is actually improving quality of care experienced by individuals. To make integrated care more than just a "pipe dream", the document argues that interventions to support integration must address issues of context, like funding and work stress, through approaches that bring together data, workforce capability, and management across services.
This document summarizes a debate about the role of the voluntary sector in health and social care. It discusses how the voluntary sector can help move towards a new era of partnership between health and social care. While integrating health and social care seems logical, cultural and structural barriers have prevented it from happening. The voluntary sector is well-positioned to play a big role because charities consider the whole person and all their needs, not just medical issues. The document also examines specific areas where more work is needed, such as how the health service can better partner with charities, how charities can save the health service money through prevention and addressing social determinants of health, and how charities can influence and create systems change within health care
The document discusses Age UK's Integrated Care Programme, which aims to provide better and lower-cost care for older people. It outlines key barriers to integrated care in England, such as political and organizational challenges. Age UK's programme provides holistic care coordination led by volunteers to help reduce dependency and isolation. It serves as a critical friend to support service redesign and has shown success in locations like Cornwall. Important aspects of the program include data analysis, whole system working, personalization, and non-medical support to help older adults remain independent.
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This document discusses establishing an Extensivist model of care to coordinate care for high-cost, high-need patients. It describes how an Extensivist clinic would function, with an Extensivist leading a care team to provide integrated care for patients' medical, behavioral and social needs. It also outlines challenges in implementing this model, such as gaining hospital privileges, changing patient behaviors, and developing new capabilities. The goal is to improve outcomes and lower costs through coordinated, preventative and patient-centered care for the most complex patients.
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John Williams, Professor of Law, Aberystwyth University Age UK
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2. Why it’s well-regarded
The Primary Care Navigator model meets a need
Provides integration across health, social care and third
sector
Makes a real difference to the experience of patients and
clinicians
Flexible, adaptable, scaleable
Is effective and efficient
3. Meeting the need
15 million people with LTCs
50% of GP appointments
70% of acute and primary care budgets
DH predicts a rise of 25% in people over 65 with one + LTCs by 2050
Cuts to local government spending have led to raised eligibility for
funded services
Consequence is more pressure on secondary and primary care
King’s Fund (Self-Management for LTCs, 2005) - people want to self
manage but need improved provision of information about their
condition and what is available locally
Statistics are people with the tears washed off
4. Meeting the need
▪ London has rich and varied provision across statutory and non-statutory
providers
▪ But patients and carers find that services are hard to locate and access
▪ Made worse by poor communication between health and social care
▪ Particular issues:
▪ Part of the solution is in social care, benefit support, housing advice –
unrecognised by people who have never associated themselves with
this need, paid or unpaid
▪ Tendency to present in a crisis and needing unplanned care
▪ Very varied availability and quality of provision – inequity
...All leading to isolation, loneliness, dependency on family members and call
on unplanned services
5. Our response
A ‘Care Navigator’ role in primary care to work across health, social
care and third sector.
▪ Three roles:
▪ Provide patient-focussed, integrated support to co-ordinate care
around the patient and navigate the system
▪ Improve planned take up of services; reduce DNAs; reduce
unplanned demand; improve communication primary/acute care
▪ Provide ‘live’ feedback on service quality to GP commissioners -
service improvement
• Role supported by mentoring and education package – quality and
consistency
6. Makes a real difference
What the GPs say:
“Having a patient navigator at the surgery has been revolutionary
for team working and patient care. Patients who were hard to
reach, often missed appointments, and paradoxically were frequent
users of non-elective care (e.g. OOH, A&E) have now had
comprehensive holistic assessments by a team of healthcare
professionals, all co-ordinated by the navigator.”
Dr Tahir, Barlby Surgery
7. Flexible, adaptable, scaleable:
Piloted in primary care
Pilot underway in a mental health team liaising with primary
care
Fits into Out of Hospital and Integration agenda
Can sit in health, social care, third sector, community –
structured around local strengths
Does not require a complex infrastructure with associated costs
Economic for a very small team, and robust for a larger one
8. Effective and Efficient: Average healthcare use
6 months before and after intervention start
GP contacts Outpatient
Significant drop
Out of hours
Significant drop
Inpatient
A&E
Significant drop
Significant drop
Significance test=Wilcoxan signed rank test
9. Potential cost savings per patient
Indicative, based on 6 months pre and post
Savings
Average Average contacts Average contacts
cost per 6 months pre 6 months post Saving:
contact intervention intervention Difference £ Saving
GP £25 8.6 4.6 -4.0 £99
Inpatient £1,825 0.4 0.08 -0.3 £584
Outpatient £160 2.9 2.3 -0.6 £96
Out of hours £45 2.3 1.2 -1.2 £52
A&E £152 1.4 0.6 -0.8 £116
£947
Costs
Navigator unit cost (incl on-costs) £303
Net savings
Potential net intervention saving per patient (over 6 months) £644
Assumes drop in activity post-intervention is all as a result of intervention. Effect of regression to the mean may reduce the calculated level of savings
However, savings may be realised over a longer period than 6 months, as modelled here. Likely savings in other aspects of care e.g. prescribing
10. Abbotts Hearing Aid centre Campden Charities Floating Housing Support Occupational Therapy
ACKC - friends & neighbours Carers Counselling Freedom pass Opthalomogy
ACKC befriending referral Carers KC Osteopathy Optician
ACKC benefits check Carers UK GP Orthopaedics Dept - St Mary's
ACKC Dementia Team CARS HF Hammersmith Hospital Palliative nurse
ACKC 'food & friends' Chelsea Theatre Health Trainers PALS
ACKC outings Chemist home delivery Healthcall (home opticians) Parkinson's Society
ACKC Practical Help CLCH Wheelchair Service Healthy Homes Peabody Tenant Support team
ACKC Shopping Service Community Alarm Service Hepatology Pepperpot
ACKC Support Broker Community Dementia Team Homeshare Scheme PhysIotherapy
ACKC Toe nail Cutting Community Diabetes Team Housing Opportunitues Team Podiatrist NHS
ACKC Toe Nail Cutting Service Community Mental HealthTeam Incontinence Service Practice Nurse
ACKC-Info & Advice Community pharmacy K&C Cruse Psychiatric Services
ACKC Escorting Cook & Taste sessions at Chelsea Theatre KCMS Quest
ACKC - Respite care Cooperative Funeral Care Learning disability Occupational Therapy Red Cross
ACKC Wayfinder Counselling Library Re-enablement Team H & F
ACKC Ageing Well sessions Crossroads Care Library Home Delivery Service Retinal Clinic
ACKC At Home Community Rehab Team Local colleges RNIB
ACKC Memory Café Cruse KC local sports facilities Samaritans
ACKC Volunteer CX Transport & Carer service Macmillan Centre at Chelwest Social Services
ACKC Decluttering Day Services Meals on wheels Stroke Association
ACKC Garden Guardians Depression Alliance Memory Service Substance Misuse Counsellor
Admiral Nurses Dietician MIND Sudanese Women's Assoc
Alcohol Resource Centre Disability Living Foundation Miranda Barry Day Centre Taxicard
Attendance allowance District Nurses Mulberry Place Activity Centre Thames Water Finance assistance
Binbrook House Support staff Dossett Box (chemists) New Horizons TMO
Blue badge DVLA appeal process NHS Direct Transport for All
British Heart Foundation Falls clinic Notting Hill Trust Vitalise Crossroads Care
Burgess Fields Support staff Falls Service Nucleus Westway Community Transport
Citizens Advice Bureau Fitness for Health Nutritionist Wiltshire farm foods
Open Age World's End Neighbourhood Advice
11. Contact
Cynthia Dize
Chief Officer
Age UK Kensington & Chelsea
1 Thorpe Close, London W10 5XL
020 8969 9105
cdize@aukc.org.uk
www.aukc.org.uk
Editor's Notes
And even within a small borough
Patient numbers Total number of patients seen: 273 Total number of referrals: 323 The navigators see an average of 141 patients in a year, 167 referrals. (4 days per week). (12 patients a month, 14 referrals a month) Social Services Out of a random sample: 15/45 were receiving social services (33%) 22/45 are known to social services (49%)