GP-led scheme cut hospital admissions 75% among elderly

A GP-led pilot to tackle dehydration in care homes reduced hospital admissions among residents by 75% and improved patients' physical and psychological health, according to the GP behind the programme.

The six-month long pilot at Springfield nursing home in Blackburn cut hospital admissions from four to just one per month, saving local hospitals at least £800 to £1,000 per patient per day, said GP Dr Tanveer Ahmed.

Patients at the care home were identified as being dehydrated by nursing staff and the visiting GP, through signs such as lethargy, reduced fluid intake, low BP, or presence of an associated infection.

These patients were given IVs of 500ml saline for three to five days in the care home setting, in addition to their usual treatments, food and oral fluids.

GP care home visits

Dr Ahmed had a contract with the care home and spent up to an hour visiting every day, monitoring the health of 14 patients.

The intervention of early saline helped cut down on hospital admissions and improve patients’ health, saving hundreds of pounds in expensive treatments and overnight stays.

He said: ‘It seems quite impressive that a small amount of IV fluid given earlier on in any kind of illness – that could be respiratory tract infections, UTIs, vomiting and diarrhoea – could have such benefits. It’s amazing how they feel psychologically a lot healthier in the same environment.

‘Once the hydration status is back towards what the human body normally has, which is about 70%, things improve quite a lot.

‘If a patient was dehydrated or feeling slightly well, they tend not to involve themselves or participate in physiotherapy. With this minimal supplementation they are much more likely to improve because they participate in the physiotherapy exercise.

‘My intervention ran for a total of six months and has seen a reduction of hospital referrals decrease from four to one per month. This has saved the hospital at least £800 to £1,000 per day per patient. This is not including the extra expense of IV antibiotics, which the patient would have received if they had been left for beyond three days without adequate hydration. If scaled across all care homes, this intervention could provide immense value to the health service.

Reduced hospital admission

He told GPonline that he was looking to get the results published in a scientific journal, as there remains to be any evidence in scientific literature that says earlier IV hydration helps patients recover faster.

The pilot showed the treatment greatly benefited patients, he added, and the results have been accepted by Blackburn and Darwen CCG.

Findings from Dr Ahmed's care home work feature in a report by an expert panel including representatives from NHS England on the benefits of care delivered in people's place of residence. The report urges the government to ‘reconsider how clinical homecare can deliver quality care in a capacity-stretched system’.

Christine Outram, chair of the expert panel, said: ‘Clinical homecare is a care strategy I feel very passionate about. During my career in the NHS, I have seen the value it delivers to cancer patients and their families, reducing anxiety, aiding recovery and improving quality of life.’

Photo: iStock

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