Health service to pilot US system to tackle admissions
pharmafile | October 28, 2003 | News story | |Â Â Â
Primary care trusts in England are to work with US healthcare provider Kaiser Permanente on new ways to reduce hospital admissions for older people and patients suffering from chronic disease.
Eight PCTs will be learning from the non-for-profit corporation based in California, which offers health insurance to eight million people in the US, and has minimised hospital stays by providing a wider range of specialist medical services in the community.
Kaiser also encourages patients to take greater control over their own care, and as a result uses approximately one third of the number of bed days as the NHS does for leading causes of admission such as asthma, bronchitis and strokes in the over 65 population.
The eight PCTs in Torbay, St Albans, Taunton Dean, Northampton, East Sussex, Eastern Birmingham , Blackpool and Lincolnshire South West are already running pilots which adapt key elements of the Kaiser model.
The link-up with Kaiser is another indication of the Department of Health's un-dogmatic approach to finding the best way of improving NHS care, drawing inspiration from the US just as the concept of foundation trusts were adapted from the set-up in some hospitals in Spain.
Health Secretary John Reid recently announced the collaboration at a meeting of international health ministers in Washington, and was keen to stress the core values of the NHS would not be affected by this latest collaboration.
He said: "We are totally committed to the NHS providing high quality care, free at the point of care, free at the point of need. But this does not mean we cannot learn lessons from insurance-based systems run by private providers elsewhere.
This is particularly the case where a not-for-profit organisation empowers patients by giving them information and helping them care for themselves. I want to learn from the market, but not copy it."
A group of NHS clinicians and managers has already visited Kaiser to see how its system could be adapted in the UK. Professor Chris Ham, director of the Department of Health strategy unit has also looked into its potential.
"The main lesson from Kaiser is its ability to minimise the use of acute hospital beds through an integrated approach to service delivery. At the heart of this approach is a strong focus on the management of people with chronic diseases and the breaking down of barriers between secondary and primary care.
"Compared with the NHS, more care is delivered in a community setting, and this includes the use of intermediate care, home care and self care by patients. Care in Kaiser is actively planned and managed and this explains its ability to deliver good outcomes with a different pattern of services utilisation to the NHS."
Kaiser has used greater integration between primary and secondary care to cut admission, with its hip replacement patients typically spending four days in hospital while the NHS average is 12 days.
A considerable amount of work has already been done in the NHS primary care field, in this respect, with the new GPs with specialist interests (GPSIs) in particular taking on patients who don't need to be admitted to hospital.
