• A Nottinghamshire MCP vanguard has had 23 per cent fewer emergency admissions for care home residents, new analysis has revealed
  • Health Foundation report shows lower A&E attendances and admissions of residents in the Principia MCP but no link to lower elective admissions or outpatient attendances
  • NHS England and the think tank have formed new unit to analyse national vanguards’ effectiveness

A Nottinghamshire vanguard has had nearly 30 per cent fewer A&E attendances for its care home residents in comparison to other parts of the country, HSJ can reveal.

A report, published today by the Health Foundation, has revealed care home residents in the Principia multispecialty community provider vanguard patch have lower rates of emergency attendances and admissions compared to patients in other parts of the country.

The analysis, shared exclusive with HSJ, found compared to care home residents in Harborough, Blaby, Test Valley, south Cambridgeshire, Chelmsford and Brentwood, Principia’s residents, based in Rushcliffe, had 23 per cent fewer emergency admissions and 29 per cent fewer A&E attendances.

However, it also found “no evidence for a difference in elective admissions and outpatient attendances”.

Principia is a partnership between 12 GP practices and community providers with support from Age UK. It focuses on offering an enhanced GP services to residents in 23 care homes around Rushcliffe.

According to the report, results indicated a “higher quality of care” for residents in Principia’s care homes, but the positive results could not be “definitively” linked to the enhanced support offered by the vanguard.

The analysis has been carried out by the new Improvement Analytics Unit, a three year partnership between NHS England and the Health Foundation to analyse the effectiveness of national programmes, such as the vangaurds. It looked at the hospital activity of 588 Principia care home residents, who were over 65, from August 2014 to July 2016 and compared them with 2,957 patients with similar characteristics.

The groups were all matched for age, gender, health conditions and prior hospital use, and measured against their A&E attendances, emergency admissions, “potentially avoidable” admissions, elective admissions, outpatient attendance, number of nights a resident spend as an inpatient after admission, and the percentage of deaths that occurred outside of hospital.

The report said despite the comparison groups’ similarities “unmeasured differences may have existed between the Principia residents and the matched comparison group, for example in the availability of informal care support or local authority funding.”

Stephen Shortt, a GP and clinical lead for Principia, said: “The essential ingredients of this model are the people involved: local GPs, community teams and care home staff all committing to working together to make positive changes in services and support for care home residents.

“This report published by the Health Foundation shows the results of the hard work and energy of the colleagues within Principia, but that doesn’t mean that this can’t be replicated in other localities with equally engaged colleagues.”

Adam Steventon, director of data analytics at the think tank, said: “In Rushcliffe, the analysis showed that care home residents in the study were significantly less likely to attend A&E or be admitted to hospital in an emergency than residents in other similar care homes.

“These results are good news for the Rushcliffe residents and good news for Principia. By enabling clinicians, care home staff and the charity sector to work together across organisational boundaries, Principia has helped achieve better care for care home residents, including fewer emergency hospital admissions. They have also achieved greater integration between health and social care services.”