Investing in extending care at home saves most of hospital costs

Investing in a New Zealand GP federation's project to treat patients in primary rather than secondary care saved four times the scheme's budget.

Professor Les Toop (Photo: Pete Hill)

Speaking at the RCGP’s annual conference in Liverpool on Friday, Professor Les Toop, head of the general practice department of the University of Otago, Christchurch, said 6m New Zealand dollars (about £3m) had been spent but four times that saved on what it would have cost to treat those patients in hospital (30m New Zealand dollars).

He explained that over the last 25 years 400 Christchurch GPs had federated to become Pegasus Health.

The organisation employs 400 staff, has a budget of 30m New Zealand dollars and serves a population of 400,000. Its 10 directors include seven GPs or nurses.

By collaborating rather than competing the GPs found that they had a way to spread best practice which could be used to tackle inappropriate prescribing.

Professor Toop added that research had shown that by taking proactive action the federation could reduce both A&E attendances and acute admissions.

He said: ‘We set up an extended care at home scheme. GPs were able to spend money on keeping a person out of hospital. This could include putting someone into bed and breakfast for a while; paying for their dog to go into kennels; or simply changing a lock on the door.’

The cost of the average package of care per patient was the equivalent of £50.

The GPs also helped to set up a virtual network without a budget which sat above both primary and secondary care and included representatives of both which decided how funds should be spent.

RCGP president Professor Mike Pringle described the case study as ‘truly remarkable’.

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