Bespoke risk stratification tool launched to help GPs deliver Unplanned Admissions Enhanced Service

NHS Arden Commissioning Support develops bespoke electronic system to support GPs in delivering their risk profiling responsibilities within the new Unplanned Admissions Enhanced Service to reduce hospital admissions

GPs throughout Warwickshire and Worcestershire are set to benefit from a new risk stratification tool that enables them pro-actively manage their top 3% of patients at risk of avoidable hospital admission or A&E attendance.

NHS Arden Commissioning Support has developed the bespoke system to support GPs in delivering their risk profiling responsibilities within the new Unplanned Admissions Enhanced Service.

With the Department of Health demonstrating that 70% of the NHS budget is spent on over 15 million people in England living with a long-term condition, the new Unplanned Admissions Enhanced Service is designed to deliver both efficiency and better care for patients.

With the onus on practices to identify those patients most at risk of hospital admission, the business intelligence team within NHS Arden Commissioning Support has developed a unique set of algorithms that allow GPs to identify and monitor their most at-risk patients.

The risk stratification tool builds on predictive algorithms developed by The King’s Fund and Bupa, and analyses over 80 variables including demographic information, previous hospital admissions, prescribed medicines, and a range of conditions.

The enhanced functionality of Ventris will allow quick and easy identification of those at risk of admission in the coming 12 months and will provide the intelligence required for pro-active case management

Using primary and secondary care data, as well as real-time information on admissions, the new reporting feature enables GPs to build registers of high-risk patients and drill down to view individual care pathways. The tool also informs practices if any at-risk patients have attended A&E or been admitted as an emergency within the last 24 hours.

Dr Alia Fahmy from Clarendon Lodge Medical Practice, who has used the new risk stratification tool to identify the practice’s at-risk patients and develop personalised care plans, said: “Risk stratification has been promoted to help reduce hospital admissions, but as an added advantage patients feel reassured that if emergency help from out-of-hours services is needed, the provider has a summary of the patient’s medical history, medication and recent blood tests results.”

The new service is available within Ventris, NHS Arden Commissioning Support’s leading healthcare business intelligence system, which is currently used by over 1,000 healthcare professionals. The web-based system helps both GPs and clinical commissioning groups understand local health requirements.

Adam Powell, business intelligence developments lead at NHS Arden Commissioning Support, said: “We have listened to the needs of GPs and have developed the risk stratification tool based on their requirements. The enhanced functionality of Ventris will allow quick and easy identification of those at risk of admission in the coming 12 months and will provide the intelligence required for pro-active case management.”

Already in use by over 200 GP practices throughout Coventry, Rugby, Warwickshire and Worcestershire, the risk stratification tool could be rolled out to other areas across the UK.

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