NCPA - National Center for Policy Analysis


May 31, 2005

This week, experts prescribed sweeping changes to the National Health Service (NHS) in Scotland which would lead to more people being treated at home or in local clinics rather than as hospital inpatients.

The group, led by cancer specialist Prof. David Kerr, urged NHS boards to do more to help patients with long-term illnesses manage their conditions at home or locally --without going to hospital.

According to researchers:

  • The combination of Scotland's aging population, the growth in long-term or chronic conditions and the routine use of inpatient hospital beds for older Scots was "unsustainable."
  • The 20-year plan also called for poorer Scots to be targeted with "anticipatory care" to prevent future ill health and reduce inequalities.
  • Kerr called for the creation of "community casualty units," staffed by a mix of nurse practitioners, general practitioners (GPs) and paramedics, who would be trained to act in 70 per cent of accident and emergency cases.
  • The units would be linked by computer to specialist centers where experts would be on hand to deal with more complex cases.

Those needing respite care should be treated in the community, Kerr concluded. Patients should also spend less time in hospital, with a reduction in overnight stays for patients waiting for operations.

Kerr identified three areas driving the need for change: Scotland's aging population, the growth in chronic disease and the growth in emergency hospital admission.

"Given the extraordinary pressures that we face it should be obvious that the status quo cannot be an option," says Kerr. "The overwhelming majority of people's health needs can and should be met locally."

Source: Louise Gray, "Home treatment plan in NHS revolution," Scotsman, May 26 2005; based upon, Astron, "A National Framework for Service Change in the NHS in Scotland: Building a Health Service Fit for the Future," Scottish Executive, May 2005.

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