GP link to social work can save NHS £1.6bn, RCGP says

GPs could be required to take CPD in social work to help break down the 'Berlin Wall' between health and care, the RCGP has suggested.

Dr Maureen Baker: backing closer GP link to social workers (Photo: Pete Hill)
Dr Maureen Baker: backing closer GP link to social workers (Photo: Pete Hill)

GP and social work leaders have called for closer collaboration to save £1.6bn and empower communities.

A joint report by the RCGP and the College of Social Work (TCSW) called for practitioner-driven integration to avert the financial crisis facing both sectors.

It called for leadership by local practitioners as well as from the professional colleges to realise community solutions to health and social care needs and shift the balance and costs away from acute settings.

Community-based care

The report backed the NHS England-supported 'house of care' person-centred model for people with long-term conditions. For that to succeed, the report said, the NHS must move away from hospital-based to community-based care with GPs supporting people with multi-morbidities, departing from the consultant-led single disease pathway model.

Such an approach could reduce hospital admissions, cut costs and improve service users’ experience, the report argues.

The colleges call for collaboration between the professions on an equal basis, rather than, as in the past, social care ‘dancing to the health service tune’.

Professional relationships should be built through multidisciplinary CPD as a prerequisite of re-registration with professional regulators.

Informal networking

Shared forums and informal networking could be used to help professionals better understand each other’s roles.

Co-location might also be part of the solution, the report said, but was not a panacea.

RCGP chairwoman Dr Maureen Baker said: ‘We desperately need more funding and more GPs but meaningful, collaborative working will also be essential to maximise the resources we have available to us in the best interests of our patients throughout the health and social care system.’

TCSW chairwoman Jo Cleary said: ‘People with long-term conditions account for 70% of acute and primary care budgets, as well as impacting hugely on council budgets, yet there is mounting evidence that this very significant sum of public money could be much better invested in community-based services with social workers and GPs in the driving seat.' 

‘It is estimated that £1.6 billion could be saved across health and social care every year by closer ties between GPs and social workers, both benefiting the people who use our services and substantially cutting the £30 billion deficit predicted by the end of the decade in the NHS as well as address the significant pressures already on council budgets.

‘Social workers, working alongside GPs, can provide strong professional leadership to drive the integration of health and social care that is needed in every locality if the care system is to be sustainable.’

Case study 1: Central Manchester Practice Integrated Care Teams

Since November 2012, 32 out of 34 GP practices in Manchester have become the focus of an integrated model of care for 500 high risk patients/service users. Social workers have contributed by helping to change the terms of the discussion. Integrated teams have moved from being 'predominantly medicine and health care based to a more rounded discussion of wider social needs'. A&E attendance and hospital stays have fallen significantly.

Case study 2: Harrow multi-disciplinary groups

Six multi-disciplinary groups (MDGs) are each attached to a 'cluster' of GP practices across the outer London borough. Social workers, nurses and hospital consultants also attend the regular meetings, where the aim is to support the 10% of the local population with two or more long-term conditions to live independently at home. Many of them can be steered away from residential or nursing home care.

Case study 3: Warwickshire ‘Discharge to Assess’ teams

The Discharge to Assess (D2A) scheme enables older people coming out of hospital to undergo a period of recuperation and rehabilitation in a nursing home before returning to their own home. Social work assessments are carried out in these intermediate care facilities, reducing delayed discharges and the overall spend on continuing health care. 'It is too early to say whether we are successful in supporting more people to live independently at home rather than in hospital or a care home,' says one of the GPs involved. 'But I do think we maximise patients’ chances of going back to their own homes.'

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