Matrons do not cut hospital admissions

Community matrons as ‘case managers' do not improve rates of emergency admissions or mortality for the over-65s, findings from the Evercare pilot scheme suggest.

Focusing on patients with at least two emergency admissions in the previous year, compared with patients at control practices, those from the Evercare scheme were 2.5 per cent more likely to have emergency admissions, and had a 5.5 per cent increased risk of mortality.  

However, they spent less time in hospital, with a 4.9 per cent reduction in emergency bed days.  

Hospital episode statistics for 62 practices in England using Evercare between June 2003 and March 2005 were compared with those for around 7,000 control practices. The pilots pre-empt the introduction of nurse-led case management in England, with 3,000 community matrons due to be in place by 2007.  

Case management was popular among patients, but experts said the cost of community matrons cannot be justified if there was no improvement to health.  

The findings could undermine some practice-based commissioning schemes which intended to save money by cutting hospital admissions using community matrons (GP, 17 February).  

Lead researcher Professor Martin Roland, director of the National Primary Care Research and Development Centre at Manchester, said: ‘It was never likely that this would make an impact on admissions, and it’s not going to save money.’  

Dr Andrew Dearden, chairman of the GPC community care committee, said: ‘What this seems to show is that patients like it because there’s someone there to talk to, which is a benefit for patients, but it doesn’t benefit patient health.  

‘Does the DoH want to improve people’s health or do they want people to feel emo-tionally better?’ 

Evercare outcomes

Emergency admissions
UP 2.5%

Mortality
UP 5.5%

Emergency bed days
DOWN 4.9% 

 

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in


Just published

Patient satisfaction screen

How a GP practice worked with patients to stop a torrent of complaints

A GP practice has seen complaints drop from 50-plus a day to just four in 10 months...

British Army soldiers marching

How the NHS Op COURAGE service can help support veterans

Armed forces veterans often have unique health needs. Clinical staff from London...

GP consultation

Continuity of care would save millions of GP appointments each year, new study finds

GP workload would be significantly reduced if continuity of care was prioritised...

Talking General Practice logo

Podcast: Visa sponsor shortage threatens GP workforce, locum GPs struggle to find work, record appointments

The GPonline team discusses the key news stories affecting general practice in our...

RCGP sign

RCGP condemns threat to retention funding as third of GPs consider quitting

Funding for GP retention risks being stripped away to cover other financial pressures...

Professor Dame Helen Stokes Lampard

Former RCGP chair joins NHS England board

Former RCGP chair Professor Dame Helen Stokes-Lampard has joined the NHS England...