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GP winter plan for Dundee and Angus hailed as a success

GP winter plan for Dundee and Angus hailed as a success

A four-month pilot scheme across four GP practices in Dundee and Angus has resulted in a reduction in emergency admissions to hospital.

Figures indicate that the success of the winter plan, which aimed to treat more patients from the Broughty Ferry, Monifieth and Carnoustie surgeries in their own homes, led to 12.2% year-on-year reduction in emergency admissions from those practices.

NHS Tayside used winter monies from the Scottish Government to test its winter plan for enhanced community support at home and early intervention pilot.

Due to the preliminary finding, NHS Tayside has agreed to support an extension of the pilot to October 31.

The pilot originally ran from December 2 to March 31 at Broughty Ferry Health Centre, Grove Medical Practice, Parkview Medical Centre, Carnoustie, and Monifieth Health Centre.

Delivering an interim report to the Dundee Community Health Partnership (CHP), clinical development manager Dr Gail Young said there were “early indications of success”.

She said: “We were the only board in Scotland who decided not to invest in the opening of extra beds but to test managing the winter surge in the community.

“We chose to focus on four GP practices with a combined population of just over 37,000, of which 24.2% were over 65 and 11.6% were over 75.

“This was not a hospital at home model. It was to prevent the need for hospital at home.”

Dr Young said the model built upon existing work in Dundee to try to treat patients at home and prevent them having to be admitted to hospital.

“The winter plan was an enhancement of what we in Dundee were already doing, focusing on frail older people when they were phoning their GP requiring a house call,” she said.

“We did some testing on whether it was a GP that needed to go out or a nurse. We carried out comprehensive geriatric assessment in the home.”

Dr Young said those involved in the pilot quickly began to see they were building up a backlog of patients and applied for an extension.

“The basic point is we looked at what practices were admitting as emergency admissions last year and this year and there was a 12.2% reduction,” she said.

There was also a 26.2% reduction in the average length of stay for the over 75s who were admitted and 18.9 hospital beds per night were saved in the project’s first half.

The committee was shown a DVD of testimonials from patients and staff.

One older patient said: “I can’t speak more highly of the kindness and the niceness of the people who come.

“It’s very good to try and keep us in our own homes. That means a lot.”

One hospital nurse praised the communication between her team and the district nurse, especially when a patient is discharged and Dr Clement said the pilot had allowed the team to be “proactive” and follow up patients more closely.

Dr Young said now that the pilot has been extended until October they would test the model and see if it could be rolled out.

“Nineteen of our of 26 GP practices (in Dundee) have now agreed to hold monthly multi-disciplinary team meetings,” she said.

“The progress we hope to make is to determine a sustainable model for roll out in Dundee. It’s all very well to have a success but now we need to make this work and make it sustainable.”