Early Trends in UK Health Programme Show Fewer Hospital Admissions and High Marks for Patient Satisfaction
January 27 2011 - 5:00AM
Business Wire
An innovative group of GPs in the West Midlands is proving that
starting small can produce big changes — and their efforts are not
going unnoticed. Pathfinder Healthcare Developments cic (PHDcic)
together with Aetna Health Services UK (Aetna) have secured their
latest award from the Health Service Journal for a programme that
aims to create systemic change in primary care. Promising early
trends indicate that one of the key interventions—a nurse-led
telephone care management service operated by Aetna—has yielded at
least a 45% lower hospital admission rate for enrolled patients
compared with a similar control group of patients not in the
programme.
Patient satisfaction survey results for those participating in
the chronic care programme have also been positive, with overall
satisfaction averaging 90%. Amongst PHDcic’s patients, an
impressive 67 percent of those invited, or 390 people, engaged in
the programme from May 2009 to September 2010.
“The early success of this programme and the award underscore
how the public and private sectors can effectively work together to
meet the needs and health objectives of the UK population,” says
Dr. Niti Pall, Chair, PHD. “It’s been two years since we began
redesigning our patient services. We have worked in partnership
with Aetna, in a collaborative manner to restructure the way our
practice delivers care to focus on value for our patients, greater
patient involvement in their care, health management and cost
reduction. This has been helped a great deal by the expertise that
Aetna bring to the table.”
The programme demonstrates one way to fight back from a
devastating report published in December by the public health
observatory showing that one-third of people in the West Midlands
are overweight, making the region the most overweight place in
Europe.
The whole system change targeted by the PHDcic-Aetna partnership
is designed to tackle the increasing cost and poor health resulting
from long-term, lifestyle conditions that contribute to poor
health, including obesity. Work is focused on specialised
interventions for people with chronic conditions; raising awareness
of available health services; and developing the local health
workforce to empower staff and sustain change.
“We are honoured to have received the Health Service Journal
award with Pathfinder and delighted with the growing success of our
care management programme. We are hopeful that our continued
expansion of the programme will validate these early results,” said
Vincent Sai, Managing Director, Aetna Health Services UK. “Patients
are at the core of the service. The goal is to inspire healthy
behaviours through motivational coaching and support by our nurses
to empower patients to make sustainable changes and manage their
health conditions. PHDcic has been an effective and innovative
change maker in the UK and proven to be an invaluable partner in
piloting this ground-breaking programme.”
PHDcic and Aetna worked together to develop a bespoke model
appropriate for the UK by translating some of Aetna’s extensive
experience in data analytics and predictive modelling technology,
which determines likelihood to be admitted to hospital or to have
future complications due to health status. In this UK model,
patients are identified for various interventions—from high
intensity, one-on-one care management support to lower-intensity
group consultations that provide peer support or online
resources.
Aetna’s care management programme is a telephone-based support
service for patients who have two or more long term conditions.
Aetna nurses proactively reach out to patients to help coordinate
their personal care needs and support adherence to medication and
GP care instructions. Early evaluation of the programme indicates
that care management is likely to produce a significant reduction
in medical costs through better preventive care and patient
adherence to doctors’ instructions
“Our goal is to provide real and effective care that improves
health outcomes for all of our patients,” said Dr. Pall. “We want
to focus on the sickest and highest users of services and also
recognise the critical need to engage with patients early on to
curb the growing trend of unhealthiness and the rising costs of
treatment.”
Underpinning these patient initiatives was money raised by
PHDcic to invest in strong medical mentoring, supervision and
performance management to develop a new workforce model to deliver
a changed service. Ultimately this work has underscored how primary
care can lead to health improvements that reduce costly and
unnecessary urgent care usage through proactive and preventative
care. Importantly it has enabled PHDcic practices to be fit for
purpose to take on GP commissioning.
PHDcic and Aetna are currently working with additional GP
surgeries in Sandwell to expand the programme to validate these
early results. Aetna also provides commissioning support including
risk stratification and telephone care management to Primary Care
Trusts and GP consortia in other areas of England.
PHDcic and Aetna won the 2010 Health Service Journal (HSJ) Award
in the category of Managing Long Term Conditions. According to the
Health Service Journal website, the HSJ Awards recognise the
innovation and inspiration that is found throughout the health care
profession today. The Awards ensure that individuals and teams are
both rewarded and celebrated for work that raises the standard of
health care in the UK. The best practices are also highlighted for
the quality of work being undertaken by all specialties and
settings. PHDcic also received a “Highly Commended” 2010
citation for the programme from the NHS Alliance Acorn Award
for excellence in the category of Service Redesign and
Improvement.
Notes to Editors:
1. Over 17.5 million people in the UK have a long term condition
(Improving Chronic Disease Management. Accessed December 4, 2008 at
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4075214),
45% of which who suffer from more than one. For patients with more
than one long term condition, health care costs are six times
higher (DeVol R, Bedroussian A. An unhealthy America: The economic
burden of chronic disease. The Milken Institute. Oct 2007.). 80% of
GP visits relate to long-term conditions. The steep rise in
diagnoses of long term conditions and increasing costs for
providing care for these patients are forcing a change in the way
that commissioners and GPs provide health services in such a way to
help manage rising costs while still providing excellent and
quality services.
2. Pathfinder Healthcare Developments (PHD) is a
Community Interest Company (cic) based in the West Midlands
concentrated in the Sandwell area. PHD is a progressive and
innovative provider of extended primary care services, specialising
in meeting the needs of inner city multiracial populations. It
currently provides a wide range of services to a population of just
over 25,000 across three practices and three sites through a
Personal Medical Services (PMS+) contract and an Additional
Personal Medical Services (APMS) contract with PCTs. It has a track
record of delivering high quality services, often leading the way
locally in the development of services, particularly to
marginalised groups. PHD has a track record of excellence
(recognised by the UK Department of Health) often leading the way
in the development of services, particularly to ethnic minority
communities, and to marginalised groups. PHDcic is seen as a
national Innovator working to incubate service redesign throughout
many strands of primary care raising the game in the UK and in
India. The UK Department of Health has recognised the standards we
achieve and the innovation we apply.
www.path-finderhd.com
3. Aetna is a leading global diversified health care
benefits company headquartered in the U.S., serving approximately
35.4 million people with information and resources to help them
make better informed decisions about their health care. Aetna
offers a broad range of traditional and consumer-directed health
insurance products and related services, including medical,
pharmacy, dental, behavioural health, group life and disability
plans, and medical management capabilities and health care
management services for Medicaid plans. Our customers include
employer groups, individuals, college students, part-time and
hourly workers, health plans, governmental units,
government-sponsored plans, labour groups and expatriates. For more
information, see www.aetna.com. To learn more
about Aetna's innovative online tools,
visit www.aetnatools.com.
4. Aetna Health Services (UK) Ltd was established in
early 2007 to offer dedicated commissioning support services to
Primary Care Trusts (PCTs), and was appointed to the Framework for
procuring External Support for Commissioners (FESC) later that
year. In 2008 Aetna was appointed to the Practice Based
Commissioning (PBC) Development Framework to provide support for
PCTs and PBCs to help them strengthen and build on local support
arrangements for practice based commissioning.
www.aetna-uk.co.uk
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