Outcomes

As part of our Health Care Home Quality and Performance Framework, we are continually developing outcome measures to demonstrate the value of the model compared to a traditional general practice

Many of our practices are in areas of highest deprivation and so we monitor changes with regard to impact on access, utilisation, patient and workforce experience and inequality.

We look at outcomes through three distinct lenses: outcomes for patients (clinical and non-clinical), outcomes for the workforce and outcomes for the local health system.

In addition to our own outcomes and evaluations, there are a number or wider evaluation reports related to the Health Care Home model of care.

Ernst and Young Evaluation of the Health Care Home 2017

Outcomes of the Primary Care Medical Home Development in the USA

Here’s a flavour of the outcomes we are achieving

Patient Outcomes

Our patients save time by having access to their clinical team by email and telephone. 35% of those ringing for a same-day appointment receive their clinical care without needing to visit the practice.

The time patients wait in the waiting room is significantly reduced as a result of our pre-consultation care before they see their GP. Not only is this a better experience for patients, practices also reduce the size of their waiting room.

Our 2015 patient survey demonstrated that over 90% of patients in our practices were very satisfied with their care, the information they received and their ability to see their doctor of choice.

Our Patient Partner Framework is further developing our work in this area including real time feedback in practices

Workforce Outcomes

The shift to a proactive and planned patient flow results in clinical staff reporting a calmer, less frenetic working day. Changes from a traditional practice day to one where the need for double bookings is removed, patient administration time is included in the daily template and an ‘off-stage’ space creates time for informal peer discussion and support all contribute to feedback, that ‘we would never go back to the old way’.

The introduction of new roles such as the Medical Centre Assistant, Physician Associates and Clinical Pharmacists has enabled all members of the clinical team to work at ‘top of scope’ and expand the skills available to the patients and the team.

The process of implementing the Health Care Home triggers practice owner discussions as to the optimum ownership model for the future sustainability of the practice. Some of our practice owners have made the shift to a salaried, partnership business model to promote teamwork and attract younger GPs into practice ownership.

We are working with Culture Amp to further develop our evaluation of workforce outcomes so watch this space!

System Outcomes

The Health Care Home model is creating additional capacity in primary care without a need for additional resource.  Offering alternative forms of access to the traditional face to face, allows the clinical team to provide more patient contacts for the same FTE.Of course, supply always needs to match demand so our work with practices makes sure that even redesigning workloads, the supply side is right.

Perhaps most importantly, the model is increasing the long-term sustainability of practices by establishing a considered, strategic business and service plan relevant to their communities and populations and creating an environment where the practice team can manage increased demand more efficiently with increased job satisfaction.

We have some early data showing reduced ED and ASH rates for HCH sites compared to the rest of the network and expect that to improve as HCH is more fully rolled out and the Year of Care programme begins to have system impact.

ED presentations T4/5 per 1000 esu
ED presentations - Health Care Home
ASH T4/5 rate per 1000 esu, monthly
Health Care Home - ASH Graph