Case study: Mid Devon GP Consortium

This case study was developed prior to the NHS Listening Exercise. The outcomes of this exercise have led to some changes to the policy, and this case study may not reflect the current policy position. More information can be found in our detailed response to the NHS Future Forum.

GPs in Mid Devon, under consultant guidance, are playing a greater role in the routine care and monitoring of some prostate cancer patients. This saves the patients multiple trips to the acute hospital, more than 15 miles away.

Background
Previously, all Mid Devon patients with prostate cancer attended consultant-led outpatient clinics at the Royal Devon & Exeter (RD&E) Hospital. Very often they would have a blood test to monitor their prostate-specific antigen levels, and if it was decided that no further intervention was needed, they would return home.

What’s being done?
GPs from the Mid Devon consortium have worked with the consultant urologist at the RD&E hospital on a pilot scheme to allow GPs to carry out routine monitoring and care of these patients, with appropriate training and under the consultant’s guidance. Following evaluation, it has been found that more than 50% of existing patients would be able to benefit from this scheme. Consultant-led care remains appropriate for the remainder.

For the patients who can benefit from the new scheme, this means they will have more of their care closer to their home, from their family doctor. However they still have the assurance that the consultant is on hand if further advice or guidance is needed.

Dr James Wood is a GP at the Clare House Surgery in Tiverton, part of the Mid Devon GP consortium. He says,

“This is a very exciting scheme developed through close working between GPs and hospital consultants. It will enable some patients to be followed up locally by their GP instead of having to attend hospital outpatient appointments. Of course, not all patients will fit the criteria for being able to be managed through this shared care scheme. Having said that, about half of these patients could be and this will be a great improvement for them.”

What are the main benefits?
The main benefit will be to patients who are saved the time, cost and inconvenience of making repeated trips to the hospital for routine monitoring at outpatient clinics. Instead they can go to their family doctor, who is familiar with their wider health issues and can provide care closer to home.

Pressure will also eased on the acute hospital outpatient clinics. Mr Malcolm Crundwell is a consultant urologist at the Royal Devon & Exeter Hospital. He says,

“This initiative is being piloted through the Mid Devon GP Consortium and so far has shown a reduction of about 50% in the number of these patients needing regular hospital visits. Instead of coming to the hospital outpatients department, patients are receiving all their care and follow-up support through their local GP practice under the guidance of hospital consultants. We are very pleased with the results so far. It means less travelling and inconvenience for patients. GPs appreciate having greater involvement in the care of their patients and this approach has taken some pressure off our busy hospital outpatient clinics.”

Next steps
If the pilot is as successful as hoped then the scheme can be rolled out across the whole of Devon.

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