NHS Lothian in £2m investment to tackle killer diseases

PEOPLE with long-term conditions will be among the first to benefit from a major new strategy to modernise primary care services in Lothian.

Healthcare staff want to focus on people with conditions such as chronic obstructive pulmonary disease, rheumatoid arthritis and other illnesses including mental health conditions in the first year of the implementation of NHS Lothian's new Primary Care Modernisation Strategy.

The plans include a £2m investment in the management of patients with long-term conditions, with the board of NHS Lothian being asked to approve the approach at its meeting on Wednesday, 23rd May.

The new funding will be made available to proposals for developments, wherever possible, from Community Health Partnerships (representing primary care) and hospital services (the acute sector), if the board endorses this proposal.

The Primary Care Modernisation Strategy, approved earlier this year, is NHS Lothian's approach to shifting resources and focus from the acute sector to the primary care sector. Over 90% of patient encounters with the NHS are through the primary care sector, and experts believe putting the accent on preventative work, maintaining good health through GPs and other healthcare professionals, will reduce the demands on acute hospital services and lead to better patient experiences.

Dr Ian McKay, clinical director of the Edinburgh Community Health Partnership, explains:

"The need to prioritise management of long-term conditions was endorsed by professionals and the public in the formal consultation on the PCMS. The strategy recommends building on the work already underway in Lothian and endorses activities such as identifying those with long-term conditions, enhancing supported self-management, targeting specific conditions, targeting at-risk groups of people and developing care plans which are anticipatory, co-ordinated and multi-agency."

He added:

"The ultimate aim is to give those people with long-term conditions the best possible quality of life by optimising control of long-term conditions. This will be by, wherever possible, preventing or slowing progression of conditions and preventing or minimising acute flare-ups which often result in emergency hospital admissions."

He continued:

"The new contracts for GPs and community pharmacists and also for consultants present opportunities for developing different service models for long-term conditions and every opportunity is being taken to realise the benefits of these opportunities."

Patient groups such as the elderly are expected to benefit most from the new approach, which will see healthcare workers collaborate more closely with local authority colleagues and colleagues from other groups including the voluntary sector.

Other benefits are expected to include savings in the acute sector as successful management of patients with long-term conditions should avoid the need for repeated hospital admissions.

One estimate suggests that the benefit from better management of people with chronic obstructive pulmonary disease, such as chronic bronchitis or emphysema, in Lothian could be as great as saving £1.2m, avoiding 4,466 occupied bed days.

The strategy runs from 2007 to 2012. The second year and later years will see the focus shift towards people with less severe and complex conditions.