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Community nurses need to convince GPs of case management value

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Community matrons and other nurses working in case management need to target their services better in order to improve outcomes and persuade GPs of their worth, according to a report.

Case management programmes assign patients with long term conditions a case manager, usually a nurse supported by a multidisciplinary team, with the aim of improving management of their condition and access to other primary services.

Health thinktank the King’s Fund evaluated a rage of case management programmes and found that, although schemes were well liked by patients, they often failed to achieve the key objective of reducing emergency admissions.

King’s Fund senior fellow Nick Goodwin, one of the report’s authors, told Nursing Times case management often struggled to achieve its aims because it targeted the wrong patients, for example those unlikely to be able to manage their own condition or not at high risk of needing admission.

Other problems identified by the study included a lack of available services in the community to refer to and case management teams not being accessible 24 hours a day. The study found most emergency admissions involving patients on case management programmes happened out of hours.

Despite problems with some schemes, Mr Goodwin said case management was a “really important way of managing vulnerable people in their own homes”.

But he also warned there was a “lack of appreciation among general practice” of nurse led case management. He said this might lead in future to some services being “disinvested in”, as GPs became more involved in commissioning services under the government’s reforms.

The GPs “think they’re already” looking after their patients without a case management approach, he said, and called on nurses to make a convincing business case for the service.

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Readers' comments (1)

  • Why can't this case management be done by District Nursing teams, we have most of te skills and with extra training could easily have them all. We are in all areas, we are 24 hours and we are the service people know and trust. Instead of this various teams have sprung up in community bringing much duplication and bewildering patients. District Nurses are being sidelined and cut but it is us who provide nursing in community for people at all stages not just for a period when someone fits into a specific category. We are fed up of being handed patients when the going gets tough by a new breed of community nurses who have a rigid and unfathomable criteria.

    I hope GP's don't commission these services but push for investment and expansion of District Nurse teams.

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