Value based health-care in Camden
Camden is a diverse and vibrant population of over 250,000 which face challenges.
- Health inequalities: Life expectancy gap is 11.6 years in men
- Elderly population: By 2017 over 85s will increase to 35% and by 2021 dementia prevalence will increase to over 25%
- Mental health: Second highest prevalence of long term mental health needs in England
- Outcomes: Above average results related to preventing people dying prematurely and below average for helping people recover and living with illness
- Value: 2nd highest spend per weighted population of London CCGs with variable outcomes and highest spend on acute in London.
Amidst these challenges, Camden has adopted an ambitious strategy to transforming care for the frail and elderly through system-wide integrated case management, placing patients and their carers at the centre of care delivery.
Co-design and co-production are at the heart of the partnership approach with providers and residents and they have adopted innovative outcome measures.
Impact achieved for the frail and elderly
Outcome measure: Number of days spent at home/not spent in hospital
- 7.08% improvement in number of days spent at home in cohort (n=93) 6 months post case management
In addition, significant impact had been achieved in other metrics:
- 51.8% reduction in emergency bed-days
- 47.7% reduction in A+E attendances
- 32.9% reduction in 1st/FU out-patient appointments
Excellent value has been generated for both the individual as well as the System
Mrs A who is a 78 year old woman had multiple hospital admissions in the last year as a result of her long-term conditions. She is the main carer for her husband who has undiagnosed dementia. Her annual cost was £9,100.
Since the programme started, assessment and care planning by MDT stabilised Mrs A’s condition and included a referral to the memory clinic for the couple. Mrs A has not been to hospital since the care plan was initiated. Her estimated annual cost is now £3,600.
Source: King’s fund, ICHP Board Seminar 6th March 2014