Viewpoint - Independent sector can bridge the gap

Consider roles for non-NHS providers in delivering NHS care closer to home, Sarah Bricknell urges GPs.

Sarah Bricknell: community-based services and ‘Big Society’ principles
Sarah Bricknell: community-based services and ‘Big Society’ principles

Bringing more healthcare services closer to patients' homes via GP surgeries will be an essential element in protecting the NHS over the long term.

Not only is there potential for significant cost-savings; there is also the opportunity to improve care at the same time.

In the eyes of the coalition government, community-based services tick a number of boxes. They match up with Big Society principles like 'localisation' and personal responsibility, and sit neatly with GP commissioning.

There is also the chance to step back from what was perceived as Labour's 'nanny state' by using local care to encourage a shift towards self care instead of automatic reliance on hospital consultations and hospital treatments. Patients want care closer to home as there is increased choice and easier access to services. For 'hospital-phobes', getting this right may mean they never have to go into hospital again.

But the main benefit will be in addressing the long-term illness time bomb. NHS figures claim that by 2050 the number of over 65s with two or more long-term conditions (LTCs) will have risen by 252 per cent, making the current approach to treatment intrinsically unsustainable. Half of the population aged over 60 and one in three of the rest have at least one LTC, such as asthma, heart or lung disease.

Reduce admissions
A number of closer-to-home schemes have run or are still running. For example, Sutton Council in London has enabled GPs to catch problems early by installing equipment in patients' homes to monitor BP and other indicators. The reduction in hospital admissions from a six-month pilot saved around £322,000.

Community matrons in Swindon help patients with LTCs by giving advice and support on monitoring BP, weight and pulse rate, and how to decide when symptoms are minor or something more serious.

Reports suggest these kinds of extended services are just unaffordable in the current spending climate. But what if providing more care in communities through GP surgeries was not about extra services and costs, but formed part of a broader cultural and logistical shift to improve care and save costs by cutting unnecessary steps in patient pathways?

It is here that independent providers could play an important role. Existing infrastructure and investment can be used as a bridge to make closer-to-home services practicable - not just as pilots, but as part of a major cost-saving transformation.

Rather than looking vulnerable to the NHS cost-cutting axe, localised services can become a stronger foundation for a truly GPand primary-care led service. But GP consortia will need to apply creative thinking and forge new partnerships to make this possible.

  • Sarah Bricknell is commercial and legal director at independent scanning and treatment provider InHealth,

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