South East Health - Out of hours medical care, Primary care health services

The Roving GP service (RGP) is a pilot project delivered via Practice Based Commissioning (PBC) in Brighton & Hove.  Running for 6 months from 1st September 2009, its aim is to reduce unnecessary hospital admissions and facilitate early discharge.  This is achieved by the provision of a visiting GP service, supported by a driver and dedicated call-coordinator.  Operating from 9am to 5pm Monday to Friday, the RGP service takes referrals by telephone from 4 main sources:

 •      Participating GP practices (at this point mainly from the West Locality)

•       Paramedic or Ambulance Technicians visiting patients

•       Rapid Assessment Clinic for Older People (RACOP)

•       Medical & Surgical Assessment Unit (MASU), Royal Sussex County Hospital

The only mandatory criterion for referral is that the patient must be registered with a Brighton & Hove City PCT practice (or participating practice, for GP referrals).

The RGP assists in assessment and treatment of patients that present with urgent healthcare needs that cannot be met by their own GP at that time due to conflicting demands, such as a pre-booked surgery or other visits; or patients who require more complex, higher intensity home support to help avoid admission or prevent a protracted hospital stay.  For Ambulance, MASU and RACOP referrals, the referrer must first contact the GP (or attempt to contact the GP) to agree RGP involvement.

Once the referral is made by telephone, and a fax/email summary of the patient’s history is sent to the RGP service, the RGP will attend and provide all necessary treatment, as well as liaising with the patient’s GP to plan any necessary on-going care.  For all GP referrals we aim to attend within 1 hour of receipt of the referral documents.

When the acute situation has been resolved, the RGP will hand care back to the registered GP along with a fully documented record of the intervention, as well as detail of any urgent diagnostics that have been arranged.  In most cases, this entire cycle will be completed the same day as the referral.

With thorough clinical, operational and financial evaluation built in from the start, the RGP service has already demonstrated impressive admission avoidance and high levels of patient satisfaction. Subject to a favourable review by our commissioners, SEHL hopes to develop this service into 2010.