A new NHS service, the first of its kind in the UK, has been introduced to speed up patient care and to allow patients to be treated closer to home. As a bonus, it cuts down the cost of medical care.

The scheme is being jointly run by Epsom and St Helier University Hospitals NHS Trust and MEDLInC (Molesey, Epsom Downs and Leatherhead Integrated Care).

Some patients who attend the accident and emergency department at Epsom Hospital are now getting some of their treatment outside the hospital.

For the last three months, A&E staff and teams of experienced local GPs have combined forces to provide a “gateway service” to oversee the follow-up care needed by patients – the first of its kind in the UK.

The gateway team reviews each case referred via the A&E department individually and plans follow-up care by integrating services across the most appropriate agencies. The team works to identify the service that best suits a patient’s needs and takes into account the distance from the patient’s home.

One 49-year-old woman attended A&E with a crush injury to her toe. As it was not fractured she could have waited up to six weeks to be seen at a dermatology clinic to have her damaged skin removed. The gateway service was able to arrange for her to see a community podiatrist close to her home within 48 hours.

An elderly lady was brought to A&E in a confused state after a fall. After a thorough examination to rule out fractures or other injuries, she was referred to the gateway team.

In conjunction with her local GP, the team was able to establish that her confusion was linked to an underlying condition (kidney failure). The team were then able to identify the most appropriate treatment, and she is now on the road to recovery.

Dr Jonathan Kwan is the medical director at Epsom and St Helier University Hospitals NHS Trust, said: “Our A&Es are extremely busy places, treating approximately 130,000 patients a year. The ‘gateway service’ means we can give even more attention to the follow-up needs of the patients who use the A&E at Epsom Hospital.”

Chairman of MEDLInC, Dr Peter Stott said: “Since its conception on April 1, the pioneering gateway has delivered for over 150 patients by improving patients’ experiences of follow-up care, relieve inappropriate pressure on hospital resources and save money for the local health economy. It is a ‘win-win’ for all involved.”

MEDLInC is a GP practice-based commissioning pilot sponsored by NHS Surrey (formerly Surrey Primary Care Trust) to provide healthcare for its population of 145,000 patients in the Banstead, Epsom, Leatherhead and Elmbridge areas.

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