Reducing hospital admissions

Dr Maureen
Swanson

NHS Western Cheshire serves a population of more than 240,000 and aims to commission high quality services that are responsive to the local needs of patients. A key component of enabling the vision has been an emphasis on the development of common and consistent pathways of care that underpin commissioning and enable the achievement of targets through system re-design.

The role for Map of Medicine

NHS Western Cheshire adopted the Map of Medicine as a means of sharing clinical care pathways across the local health community. By providing a framework of evidence based, peer reviewed best practice guidelines, the Map provided a focal point for the redesign of local pathways. One of the first pathways to be clinically localised in Western Cheshire using the Map of Medicine was the Cellulitis Pathway.

Milestones

• The localised NHS Western Cheshire Cellulitis Pathway was used to communicate the introduction of new procedures to enable otherwise healthy adults to be treated with intravenous (IV) antibiotics in the community.
• The NHS Western Cheshire Cellulitis Pathway was launched at a well-publicised event for the existing GP network, other clinicians were invited and presentations included the A&E perspective and the role of the Map of Medicine.
• By 2009, more than 60% of Western Cheshire GPs were registered users of the Map of Medicine.

Challenges

• Engaging clinicians
• Communicating the detail of the redesigned pathway.

Results

The deployment of the Map of Medicine has been a key enabler in helping the local health community achieve to the benefits of information technology and online care pathways. The creation of the NHS Western Cheshire view of the Map of Medicine and using it to communicate the local Cellulitis Pathway to staff has successfully controlled and reduced the number of hospital admissions from up to 40 to around 20 per month. The total cost of treatment in the community depends on which drug is used and how many injections are given, but the average cost can be up to £200. Measured against a two day hospital admission, the minimum saving per patient of treatment in the community exceeds £2,000.