Cost-saving model seeks to improve doctor visits

Health Care Home scheme to end long waits and free up GPs for complex cases

Natalie Akoorie

A shake-up in the way patients visit their GP could spell the end of long waits and short consultations, a report shows, in what could save millions of dollars in hospital care.

The Health Care Home model, in

128 general practices across the country, is helping keep urgent care needs out of crowded hospital emergency departments.

Initially controversial, the model allows patients to first speak to their doctor by phone on anything from advice and prescriptions, to specialist referrals and lab tests.

GPs are being freed up to deal with complex cases and longer appointment slots and time for paperwork to keep doctors from burning out.

One GP, who has written an open letter to hundreds of colleagues, said his practice would “never go back”.

According to an evaluation of the model by Ernst and Young, patients in practices operating Health Care Home (HCH), have significantly increased access to a GP and better long-term health plans.

The analysis found:

● 14 per cent fewer patients presented at ED, including 24 per cent fewer Maori and 32 per cent fewer pensioners.

● 62 per cent of same-day appointment requests managed without need for a GP visit that day.

● Fewer referrals to specialists.

● 20 per cent of patients less likely to attend a hospital with an avoidable health issue.

The model was developed by Pinnacle Midlands Health Network when, in 2008, the organisation that represents 400 GP practices began a planned response to growing demands, changing populations and workforce expectations.

John Macaskill-Smith, chief executive of Pinnacle subsidiary Ventures, said the system helped address the problem of patients not being able to get a same-day appointment, by valuing the time of patients and clinicians.

EY compared 83,000 patients in 14 Pinnacle HCH practices with the same number from non-HCH practices, finding a significant proportion of acute need was being prevented or successfully met.

If the model was in 75 per cent of Pinnacle practices instead of 9 per cent and with similar results, it could equate to a reduction of $25 million of hospital care per year, MacaskillSmith said.

Dr Brendon Eade, a GP owner at Health Te Aroha Medical Centre where HCH began in 2013, said there had been mixed support for the model.

“But the benefits to practices, patients and the broader system are really clear,” Eade said. “I feel like I’m doing good quality consultations where previously I was doing rushed, rapid consultations . . . because of the stress of the system.”

Ministry of Health service commissioning deputy director Keriana Brooking said the ministry supported work in the sector to improve primary care models, and HCH was an example of that.