Manchester local medical committee’s (LMC) chief executive has revealed plans to move emergency departments out of hospitals and into communities by 2020.
Dr Tracey Vell told delegates at the Management in Practice Manchester event yesterday that “the emergency departments, apart from ambulances, will not be in hospitals for very long”.
Noting the national drive to keep patients out of emergency departments, she explained to Management in Practice: “Most patients don’t want to go to hospital. There’s nowhere to park and they sit for hours with the majors that the staff are shared over. So it makes sense to move it into the community.
“Doing that gives a viable alternative instead of just telling patients off for where they want to access care. They’ll access care where ever is easiest.”
With emergency departments, admissions and timely patient discharge the top problem areas financially, Vell adds that in-community urgent care will not stand on its own.
“It will be a holding ground for patients before they go into hospital and an easy out of hospital, so it will be embedded,” she said.
Vell described a “line of ambition between now and 2020” when she expects emergency department work to be undertaken at a community level throughout the Greater Manchester area.
However, Stockport and City of Manchester will be among the first areas to offer these services.
“Not every borough in greater Manchester would be starting at the same time because that would be risky,” she told delegates.
The shift comes as part of a wider devolution that Vell said will “radically transform” the city’s primary care.
NHS Greater Manchester released a report, Taking Charge of our Health and Social Care in Greater Manchester, last December detailing plans following the devolution of public services to the city.
The report said the area “has one of the highest rates of emergency hospital admission for conditions that would be better treated in the community”.
Furthermore, the five-year plan vowed to develop local care organisations “where GPs, hospital doctors, nurses and other health professionals come together with social care” to deliver care, leading public services to be accessed “largely in their community, with hospitals only needed for specialist care”.
However, to achieve this, “will require some organ donation from secondary care,” said Vell. “We need to transplant something from secondary care into primary care. Maybe the heart of secondary care.”
With the introduction hubs, covering populations of 30,000 people, Vell said the new scheme will not be a further burden on GPs and instead will use pharmacists and other care workers.
She said: “General practice will look over the more complex cases and the urgent cases but some of the things that we currently do which are bureaucratic could probably be done by other people.”
Beyond 2020, Vell said the LMC would move to tackle homelessness, sickness benefits and unemployment with the help of the social care system.
Often hearing that collaboration between the health and social care systems will shrink budgets, Vell said: “They’re great partners to have because they actually widen your outlook and they have great ways of commissioning.”
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