Over 75s Project

SWGP has been successful in its first bid for funding, which will see practices providing enhanced services for patients aged over 75.

Over 75s Pilot Summary

Over the last 12 months SWGP has worked collaboratively with Age UK Warwickshire and 31 of its GP practices to establish a proactive mechanism whereby patient’s needs, whether clinical or social are identified earlier, increasing quality of life and reducing risk of hospitalisation. The integration of Age UK GP Navigators within the GP practices has extended the practice reach into the social and emotional aspects of prevention. Depression and social isolation affect one in seven people over the age of 65 (Graves et al 2006) and this project has allowed for the earlier identification of this and subsequent care to be put in place. In addition to this, to date, at least 95 new diagnoses of dementia can be attributed to this project, as well as 85 new cases of Atrial Fibrillation.

Activity

patients underwent an enhanced clinical review incorporating components of the British Geriatric Society’s ‘Comprehensive Geriatric Assessment’

patients referred to Age UK for a holistic needs assessment.

Outcomes

  • Reversed the upward trend of non-elective admissions for over 75s: 2.6% reduction in year on year Non-elective admissions, compared to a rise of 5.3% in the previous year
  • Halted the upward trend of A&E attendances for over 75s: 0.2% increase compared to a rise of 8.6% in the previous year
  • Earlier diagnosis of Dementia, Atrial Fibrillation and Depression in the elderly.
  • 98% (2198/2244) of patients agreed that the enhanced clinical reviews has ‘been beneficial to their health’
  • Better integration of services to provide more joined up care for the elderly

Year 2

SWGP is delighted to announce due to the positive impact of the pilot project, the CCG has agreed to commission the scheme for at least another 2 years. Refinements have been made to ensure any learning from year 1 is implemented and the elderly patients of South Warwickshire can continue to access an enhanced and vital service.


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