Medical Matters:'GPs to carry out routine follow-up of patients after surgery" was just one of the headlines that greeted a new report on developing primary care in Britain.
Published earlier this month, the report by Dr David Colm-Thome, national director for primary care in the NHS, listed a number of ways that patient care could be moved closer to people's homes.
He outlined a "one-stop model" of general practice, where GPs could refer patients to consultants who worked down the corridor in cottage hospitals and revamped primary care facilities.
Operations such as cataracts, hernia repair and surgery for varicose veins could be done on the same site by GPs with specialist skills working alongside senior consultants, Colm-Thome said.
The report describes just such a practice in Epsom, Surrey where almost 8 per cent of patients previously referred to hospital for routine care are seen by GPs, nurses and consultants. And while a blanket decision that all post-operative patients be seen by a GP could be dangerous - what about a person with cancer who has lots of questions that only the surgeon can answer - it is estimated that such a move could save the NHS in England some €2.8 billion a year.
Could any of the recommendations in the report, Care Closer to Home, be applied to our beleaguered health system? In theory, the answer is yes. But we first need to take smaller, more practical steps to improve primary healthcare in the Republic before the new UK model could become a reality here.
Since the 1970s, general practice in Britain has been organised around multidisciplinary primary care teams. Doctors, nurses and paramedical staff provide personal care to a shared list of patients.
Until recently, such a team model did not exist in primary care here.
Following his appointment as Health Service Executive (HSE) supremo, Prof Brendan Drumm made it clear that he saw the development of primary care teams as the key to health service reform.
According to the HSE, of 100 such teams announced in 2006, some 84 teams are now in place, with the northeast region on course to be the first area to have full coverage, with 40 primary care teams due to be set up there by the end of this year.
Funding for a further 40 primary care teams, and 300 healthcare professionals to staff them, was announced in the 2007 Budget.
A typical primary care team will serve population groups of around 10,000, bringing together GPs, practice nurses, physiotherapists, occupational therapists, public health and community psychiatric nurses and home helps. Extended team members, including speech and language therapists, dietitians, psychologists and social workers, will serve a network of about five care teams, or 50,000 people.
What will this mean for patients? They should experience a more integrated level of care.
Take a person recovering at home following a stroke. An occupational therapist, physiotherapist and public health nurse will work together, using a shared clinical record, to rehabilitate that person and ensure that maximum recovery is achieved.
And the team members will liaise closely with their counterparts in the hospital where the person was initially treated, helping to break down the barriers that presently exist between primary and secondary care.
So much for the theory. Does it work in practice?
Ballymun Primary Healthcare Team is already up and running and serving about 8,000 people on the northside of Dublin. As well as seeing their general practitioner, patients have access to an occupational therapist, physiotherapist, clinical psychologist, as well as a speech therapist and dietitian, all in the one location. Public health nurses and community mental health nurses are also located in the facility.
As a result of the new team approach, there are now regular sexual health clinics, minor surgery clinics, sessions dedicated to people with diabetes and a multidisciplinary falls clinic at the health centre.
Because she now has access to clinical psychologists on site, one GP says she has been able to reduce her prescribing of antidepressants and dramatically lower her referral rate to consultant psychiatrists.
Clearly, there is huge potential to develop primary care in the Republic.
But before we add the latest NHS ideas, we must first learn to walk by developing a countrywide network of primary care teams, properly resourced and available to everyone in the community. We must also address the manpower problems that have seen the recruitment of just 20 per cent of the 300 healthcare professionals who were due to join primary care teams in 2006.
And, as Dr Garrett Igoe of the Virginia Primary Care Team said last week in a letter to this newspaper on the topic of developing primary healthcare: "I hope the resources will be made available to push through this very necessary reform."
Muiris Houston is pleased to hear from readers at mhouston@irish-times.ie but regrets that he cannot answer individual queries.
