Abstract Body

Background

Evidence shows seeing the same clinician over time reduces morbidity, mortality, and the use of health resources. It’s beneficial for both patient and clinician. The Health Foundation funded five UK sites, covering 0.5 million patients, (between 2019 and 2021) to explore how to improve levels of continuity of care and to assess the impact. In this presentation, we share the learning. It includes a comprehensive Toolkit providing clear, practical advice from healthcare colleagues and patients

Aims and learning objectives

To increase awareness of the link between continuity of care and positive outcomes for both patients and clinicians

To share the outcomes of the Health Foundation continuity programme.

To present the Toolkit to enable participants to support both practice staff and patients with their continuity of care improvement journey.

Methods and timetable

We propose to:

Review the evidence that relational continuity improves healthcare (15 minutes)

Outline the findings from the Health Foundation Programme. (15 minutes)

Host an Interactive Session including a demonstration of the Toolkit (60 minutes)

We will take participants through sections of the Toolkit and using the chat function and polls enable reflections and questions on their own practice.

Participants can try the Toolkit prior to its national launch with the UK Royal College of General Practitioners in Summer 2021.

Results/Conclusions

Participants will learn why and when continuity of care is important to both patient and clinician wellbeing. Using the learning from the Health Foundation Programme and access to the new national Toolkit we will equip them to embark on improving continuity of care in their practice.

Abstract Body

Background and purpose

Covid infection is associated with an unpredictable, rapid, fall in oxygen levels for some patients, which can be overlooked as silent hypoxia. Detecting this fall can help improve survival by providing earlier treatments, such as steroids and high flow oxygen. Home oximetry was a management option that emerged early in the Covid pandemic, but is still not yet widely applied. Oxygen saturation monitors are readily purchased by individuals and their use is now supported, as a priority, by Public Health England and, internationally, by the World Health Organisation (WHO).

Methods

We provide case reports, description of service development, and analysis to outline the development of one of the first UK supported home oxygen saturation self-monitoring services and its impact within one English Clinical Commissioning Group (CCG), covering 550,000 people.

Results

We present the case report that triggered the provision of oximeters to patients in March 2020 and led to the development of a full service in West Hampshire CCG. The outcomes, including policy adoption in the UK and WHO, and the development of analysis by university partners will be presented. Cut off oxygen levels for admission and treatment will be outlined. Early patient feedback indicates increased feelings of support and that older patients prefer telephone support to digital solutions.

Conclusions

Oxygen saturation self-monitoring for Covid is achievable and a good example of integrated care and system working. It empowers patients and, has potential to reduce admissions, morbidity and mortality. As a relatively low cost intervention it can be instigated by patients independently or in conjunction with healthcare providers.

Abstract Body

Background and purpose

For consultation length the UK is an outlier, with shorter GP consultations than most countries. Over the last twenty years Uk consultations have moved from seven minute to an average of twelve minutes. At the same time the consultation has become more complex with most chronic conditions managed in primary care. Longer consultations have been shown to be more patient centred, but the UK has disincentives to a longer consultation. Policymakers do not actively support a model of longer consultations and general practitioners are not aware that a twenty minute model of consultation can work in practice.

Methods

This presentation includes a review of the literature on the impact of consultation length, and a description of a models of care that provide the option of twenty minute routine appointments to all, or part of, a list of registered primary care patients in England.

Results

We will outline the existing pattern of consultation length in England compared to Europe, and the literature associated with the benefits, disadvantages and disincentives to achieving longer consultation length.

This will be followed by the description of working models for the application of twenty minute appointments, the blocks overcome, and the development of resources to support these.

Conclusions

The benefits of longer consultations outweigh the disadvantages, but limited overall capacity for healthcare and reduced income are key drivers that oppose an increase in consultation length. This is the first report that models for routine twenty minute appointments in the UK NHS do exist and can be applied more widely in UK general practice.