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Given today’s economic pressures, the current business model of a health system based largely on acute hospital care is no longer fit for purpose. Hospitals are expensive places for people to stay yet doctors often have little option but to recommend in-patient care, owing to the inefficient linkages between primary, secondary and community care.
For some patients, in-patient admission may not actually produce the best outcomes and can serve to keep them away from home longer than may have been clinically necessary. Many such patients are from our growing elderly population and have multiple, increasingly complex, health challenges. This only serves to place further strain on hospital capacity and results in increased costs to the system.
The frustration here is that there appears to be widespread acknowledgement among clinicians and managers of the model’s shortcomings. However, tackling the issue will inevitably result in closures in hospital capacity. This is where politicians’ and the public’s commitment to their local hospital becomes a major stumbling block to better, more efficient care.
Better education of the general public around the new models of care will be an essential part of any move away from acute-based care – and I believe that this will be a key part of the GPs’ new role as commissioners.
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