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Published: 5 February, 2015
An innovative scheme has led to 469 Greater Manchester patients avoiding unnecessary admission to accident and emergency departments throughout December.
At a time when pressures on A&E departments has been much publicised, this work has saved in excess of £300,000, more than 400 bed days for the NHS and reduced the number of ambulance journeys, as well as giving better care, closer to home for patients.
The scheme, called ‘Alternative to Transfer’, is run by gtd healthcare, working alongside the North West Ambulance Service (NWAS). It began in Central Manchester, and since then has been commissioned in other areas within Greater Manchester and in South Sefton.
The scheme has been operating 24 hours a day, seven days a week, in Central, South and North Manchester, Oldham, Tameside and Glossop, for more than 12 months, and was launched in South Sefton this month.
‘Alternative to Transfer’ provides alternatives to hospital transfers by enabling paramedics to refer patients to a gtd healthcare GP, offering a comprehensive urgent care service within the community.
The paramedics use a ‘pathfinder’ tool, which includes a series of medical questions and assessments to triage a patient. These include the patient’s temperature, history, pulse, pain levels and so on.
The outcomes of these questions and assessments creates a score, which helps the paramedic to decide whether a patient may benefit from a referral to a GP before a decision is taken about what care they need.
If a patient is identified in this way, gtd healthcare provides a GP within 15 minutes to accept the referral (if appropriate) and undertake an assessment over the phone.
The patient may then be given self-care advice, the GP may visit them in their home, attend a treatment centre, or they may be referred to an appointment with their regular GP or another community service.
Alternatively, if the GP thinks it is the best course of action, the patient may still be taken to A&E. However, on average, 92 per cent of patients dealt with by gtd healthcare GPs do not need to attend A&E.
‘Alternative to Transfer’ has proved extremely popular with patients, who report being delighted to receive appropriate care in or near to their own home where possible.
One patient from South Manchester, aged 84, who saw a gtd healthcare GP following a paramedic assessment and was able to stay at home and make an appointment with her regular GP, said: "I was so happy that the doctor was going to come out and see me, as I didn’t want to go to hospital, especially as my daughter was away.”
The scheme has also provided benefits to the paramedics, who are able to seek advice from GPs in situations where they think a patient may not need transfer to hospital.
The conversations that paramedics have with GPs about patients also helps with their personal and professional development, and gives them more support, confidence and experience to make decisions over the appropriate treatment for their patients.
A paramedic, who used the service twice in quick succession, said: "I have no doubt that both patients, as well as the A&E and the local NHS, benefitted as a result of the patients being appropriately and sensitively dealt with by the GP. Forging strong inter-agency links like this is what the future of acute care will be based on.”
David Beckett, chief executive of gtd healthcare, said: "gtd healthcare and NWAS pioneered the Alternative to Transfer scheme, which has since been extended across other parts of of Greater Manchester, and is something that we are naturally really proud of, but over this winter, it has really come into its own.
"The scheme is a perfect example of local services working together to deliver care as close to patients own homes as possible. It offers clear benefits to the local health services at a time of great pressure, and most importantly in a way which makes a real positive difference to patients’ experience. Now we are delivering the scheme in South Sefton, even more patients, families and communities can benefit from it.”
Julie Butterworth, Interim Pathfinder Regional Manager at NWAS, said: "GP referral schemes serve to support patients to receive the right care, at the right time, in the right place, in line with their individual and immediate care needs.
"NWAS clinicians clinically assess patients on scene and if appropriate will seek to organise a referral to a local GP scheme. These innovative alternatives to being taken to hospital provide patients with care in line with their immediate and ongoing care needs.”
