Clinical efficacy of continuity of GP care versus care plans and MDT meetings (From the Journals, p 72, 18th January 2020)
Dear Editor,
Dear Editor,
Alex Nowbar in his research review "Healthcare hotspotting for superutilisers" (From the Journals, p 72, 18th January 2020) seems surprised that intensive clinical and social input did not reduce readmissions of patients with complex conditions. This is not unexpected.
The Avoiding Unplanned Admissions DES, which operated along similar lines, was eventually scrapped after evidence showed that GP practices with more patients on care plans had higher rates of unplanned admissions than those with fewer care plans. In spite of this, the new draft Network Contract DES is suggesting the same interventions - personalised care and support plans for all patients with frailty or complex needs and regular MDT meetings to discuss these patients. It is a pity that NHSE and NHSI have not considered the wealth of evidence which already exists to show that these measures are not helpful in reducing morbidity, mortality or hospital admissions.
There is good evidence that continuity of care with one clinician does improve health outcomes and reduce unplanned admissions. This is becoming increasingly difficult to deliver due to the demands for time to be spent attending PCN and multiple other planning and review meetings which prevent GPs from providing the consistent good clinical care they aspire to.
Rapid Response:
Clinical efficacy of continuity of GP care versus care plans and MDT meetings (From the Journals, p 72, 18th January 2020)
Dear Editor,
Dear Editor,
Alex Nowbar in his research review "Healthcare hotspotting for superutilisers" (From the Journals, p 72, 18th January 2020) seems surprised that intensive clinical and social input did not reduce readmissions of patients with complex conditions. This is not unexpected.
The Avoiding Unplanned Admissions DES, which operated along similar lines, was eventually scrapped after evidence showed that GP practices with more patients on care plans had higher rates of unplanned admissions than those with fewer care plans. In spite of this, the new draft Network Contract DES is suggesting the same interventions - personalised care and support plans for all patients with frailty or complex needs and regular MDT meetings to discuss these patients. It is a pity that NHSE and NHSI have not considered the wealth of evidence which already exists to show that these measures are not helpful in reducing morbidity, mortality or hospital admissions.
There is good evidence that continuity of care with one clinician does improve health outcomes and reduce unplanned admissions. This is becoming increasingly difficult to deliver due to the demands for time to be spent attending PCN and multiple other planning and review meetings which prevent GPs from providing the consistent good clinical care they aspire to.
Sheila Jackson
GP
sheila.jackson@nhs.net
Competing interests: No competing interests