GP streaming in A&E departments – update on the impact and how to implement

 

After Simon Stevens announced all hospitals must have front door emergency department clinical streaming rolled out by Christmas 2017, Lantum has been inundated with requests from providers to help with implementation.

 

GP streaming is part of the urgent care agenda put forward by NHS England (NHSE) in the 5 Year Forward View to address the increase in the number of attendances to Emergency Departments. The aim is to replicate the primary care setting as a ‘front-of-house’ service, stream patients from A&E back into primary care, as well as educate and navigate where their care needs can be met in the community and primary care. Some estimates suggest that between 1.5 and 3 million people who attend A&E each year could have their needs addressed in other parts of the healthcare ecosystem. Patients treated in urgent care centres costs around half what it would compared with A&E, creating significant savings for the NHS both at local and national levels.

 

Lantum are assisting to operationalise a variety of delivery models. The Luton and Dunstable Model (L&D), is the recommended delivery model from NHSE. This is where senior clinicians (e.g. Advanced Nurse Practitioners or Paramedics) triage the patient; alternative models utilise GPs to perform the triage function with each having it’s advantages. The L&D model addresses the current GP workforce shortages as well as having lower staffing costs. The evidence is yet to be determined as to which model works best.  Dr Ishani Patel, GP and Cofounder of Lantum recommends providers to communicate and patient involvement to address concerns raised by patients who expect to consult with a GP.

 

How Lantum has helped:

North Middlesex Hospital rolled out GP streaming over a year ago. We supported their vision by creating an online staff bank enabling service managers to post rotas and fill the sessions using their trusted GPs within hours. Doctors are matched with shifts through the iphone app and store all of their compliance documents on their profile.

 

With the use of algorithmic matching and machine learning, the rota was forecasted and fully staffed four months ahead of time at a fixed rate with minimum effort. If bank GPs were unable to work the shifts, local GPs external to the bank can source them via Lantum and sustain the supply of service. North Middlesex has saved £100k per annum on saved agency fees whilst freeing up crucial service manager time.

 

Salford Primary Care Together (SPCT), a GP provider Community Interest Company are contracted to deliver the ED Primary Care streaming service in Salford.They chose the Lantum platform to host and fill their rota 12 hours a day, 365 days a year. Furthermore, the local GP population in and around Greater Manchester continue to use Lantum to manage their work commitments in addition to booking the shifts at Salford Primary Care Together. This has enabled wider GP engagement and offered stability to the service with 100% of shifts for November fully supplied. SPCT and Lantum are embarking on the next phase of collaborative working to explore the workforce management and service re-design of Urgent Care Treatment Centres.

 

If you are interested in hearing more about how we have helped please email scott@lantum.com

 

Authors:

 

Dr Ishani Patel

Melissa Morris

Co-founders Lantum

www.lantum.com

 

 

 

 

 

 

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