Where is the best place to keep essential information? On the fridge door is the answer our practice-based commissioning (PBC) cluster in Stoke on Trent came up with.
We commissioned a colourful 15cm by 21cm fridge magnet made of plastic that lists local healthcare services and advises when it is appropriate to use each one. Each household in our PBC group's area was recently sent a magnet.
Avoiding A&E overuse
We wanted to encourage patients to use GP services whenever possible rather than A&E or our local walk-in centre. Most surgeries have good same-day access and run evening or Saturday morning surgeries but, at times, there are corridors full of patients waiting at A&E.
An incentive was that our cluster can fund new primary care-based services from the underspend on secondary care.
The cluster works closely with the PCT which supplies data about patients who visited A&E at least three times in a six-month period. Data for the nine practices is compared; each practice reviews whether visits to A&E were warranted and, if not, whether it can do anything to cut the patient's visits.
Some practices phone frequent A&E attenders. At our practice, we flag the electronic records of the few who we think can be influenced. But at least half are already receiving care for alcohol or other substance misuse, and often attend A&E with physical injuries at night and weekends.
We designed the fridge magnets to reach all our cluster's 41,000 patients. They complement local newspaper adverts placed by the PCT to highlight appropriate A&E use and to encourage people to make better use of local pharmacies and their GP practice.
The magnet will hopefully be displayed on our patients' fridges for many years.
We bought 21,000 magnets: enough to send one to every household on each practice's list and to provide practices with a spare thousand or so to give to new patients and distribute at practice-run health promotional events or other appropriate occasions.
The project is run by the cluster's practice manager lead. She arranged for registered patients' addresses to be extracted from the Exeter payment system and printed onto address labels.
The magnets were despatched to each surgery in pre-stamped envelopes with address labels. All practice staff had to do was stick a label on each envelope, and mark the back of it with their practice stamp to identify where the magnet had come from.
We are now waiting to see if we have made an impact on A&E attendance rates and whether the £16,000 or so PCT funding to buy and distribute the magnets was a good investment.
- Dr Chambers is clinical lead and Elaine Wilkinson, practice manager lead for the North Eastern A practice-based commissioning cluster, NHS Stoke on Trent