Placing a GP and a nurse outside A&E to redirect patients could save the NHS millions and alleviate pressure on hospitals, a trial has found.
Since the start of December a group of GPs have been testing a scheme which places two practitioners at the front door of a hospital’s A&E department.
The duo help assess patients when they arrive and then redirect those who do not need urgent care elsewhere.
As many as 75 patients have been redirected in a single day at Northwick Park Hospital in Harrow, North West London, for ailments that could easily be treated by a GP or even a pharmacist.
While some turned up for recurrent problems, such as a bad back, one patient even went to A&E because they had run out of Calpol.
The doctors working at Northwick Park Hospital, London, said that the scheme could save the NHS up to 30 per cent in costs. (Pictured: Ambulance outside the hospital)
For the tests two practitioners were placed outside the entrance to Accident and Emergency at Northwick Park Hospital, London (pictured)
Instead of spending hours in the emergency waiting room, creating a backlog in an already-stretched system, they were given the option of booking a local GP appointment that very same day or the next morning.
Those behind the trial predict the scheme — which has redirected 700 patients in total so far — could save the NHS up to 30 per cent in costs and help ease the current pressure on hospitals caused by Covid.
The pilot, which is in place until the end of March, has been commissioned by local NHS leaders and organised by Northwick Park Hospital and Harrow Health — a not-for-profit organisation run by a group of GPs based in Harrow.
NHS waiting list could DOUBLE to 12 million in just four years
NHS waiting lists have spiralled to a record 6million people in the wake of the pandemic.
But a damning report from the National Audit Office (NAO) has predicted it could double to 12million by 2025 despite billions more being pumped into the health service.
Even in the best case scenario where the NHS ramps up appointments by 10 per cent, the NAO said the waiting list could still grow to 7million by 2025.
Its report, published in December, also warned the health service was falling dramatically short on all key targets — including cancer care — with the ‘catastrophic’ consequences costing lives.
And it suggested Boris Johnson’s controversial ‘health and social care levy’, which will raise national insurance payments by 1.25 per cent, would be inadequate to prevent hospital waiting lists surging further.
Dr Kanesh Rajani, chairman of Harrow Health and a GP himself, said: ‘People go to A&E because they know it’s there.
‘They know that they can access it easily, and they can be seen by a healthcare professional for the problem, but it may not be the most appropriate place for them.
‘The sorts of things people come in for – whether it be a shoulder problem or muscular injuries they’ve had for days or weeks, or a cough they’ve had for a long time, or vomiting and diarrhoea – they want help and advice but they may not know a pharmacist can help them or their local GP.
‘The doctor and nurse will be able to help them and make an assessment and appropriately signpost the patient to the right care.’
The GP and nurse stationed at the A&E front door are accompanied by administrative staff, who can assist with booking appointments for patients.
Harrow Health CEO Adam Mackintosh said: ‘Additional GP appointments have been created within the system, and we have increased the amount of ones that are available to support the pilot.
‘GPs across the area have also been very receptive and when we’ve called them to say their patient is in the emergency department and they don’t need to be here, they’re extremely accommodating as well.
‘We have had excellent feedback from the hospital. They say if we can even redirect 10 patients a day that makes a huge dent in what they have to deal with.
‘Redirection seems to work extremely well in directing the minor illnesses away from hospital where they don’t need to be.’
Despite the scheme being especially important during the current Covid wave, Mr Mackintosh said he also believes it could be extremely valuable during the regular winter period.
‘What this could do, if continuing to work well and once qualified as a successful pilot, could become an amended model of urgent treatment care at the front door,’ he added.
Although the trial is still ongoing, it has already been so successful that there are already discussions about replicating the model in other systems and hospitals in North West London.
A total of two million A&E attendances in England were recorded in November last year – up from 1.5 million in November 2020.
A report on A&E waiting times in England, carried out by NHS Digital in 2019, found that around nine per cent of people who attend A&E are discharged without requiring treatment, and a further 32 per cent receive guidance or advice only.
Each trip to A&E – even before any specialist treatment – can cost the NHS up to £419, according to analysis by specialist injury lawyer firm Hudgell Solicitors.