Chris Ham in conversation with Craig Tanio

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Chris Ham, Craig Tanio

Chris Ham speaks to Craig Tanio, Chief Medical Officer at ChenMed, about how the US-based primary care-led delivery model offers care to older patients with complex needs.

Chris Ham in conversation with Craig Tanio

Craig talks about the innovative features of the model, which include a one-stop shop for patient care with a range of other services like diagnostics and acupuncture provided onsite, a low patient-to-doctor ratio, and close partnership working between clinicians and specialists. He also explains what's changed for patients and staff as a result, and what inspiration clinicians in England could take from the model.

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Comments

#114530 David Dundas
Managing Director and NHS Trust Governor
Lion Industries UK Ltd

I have long thought that the main problem with the overall quality of patient care, is the long time it takes to diagnosis at the Primary Care level, because GPs have to use many other providers for their diagnosis with each step often taking several weeks, which when added together leads to a long time for diagnosis, especually for those patients who have more complex needs, such as the elderly. ChenMed reduces the time for diagnosis by bringing most of it in-house. At present our GPs get around this problem by sending the patient to hospital which speeds up the diagnosis pathway. The advent of Critical Assessment Units recogises this problem.

#114591 Mick Smith
Retired
two: sailing and snooker for the disabled

In our country we have Healthy Living Centres each of which provide exactly the kind of thing provided by ChenMed. In my opinion we ought to have centres like this (with huge car parks) that can house both NHS and both private sect0or and voluntary sector partners. Here you could also have facilities for consultants to work from and this centre could also house the out of hours services too. Even better, some minor operations could also take place here. The doctor section then, could easily be kept open 24/7/365.

#116826 Keith Hodge
GP
HVCCG

One GP to 450 patients, wow! With most Practices functioning at one GP to c.1500 to 2000 patients, we would need a massive workforce expansion to replicate this model.
I think the other point is that it breaks the cradle to grave, vertical approach to primary care, and implies that other groups of patients ( children, younger adults) are also being looked after by specialist teams of GPs. That may superficially seem to be a sensible approach, but would lessen the generic skills of GPs in the 24/7 Urgent Care setting who are needed to safely assess a neonate one minute and a 90 year old the next. ChenMed sounds fantastic but I would be cautious about the unintended consequences.

#463499 Zahira Bachelani
GP
BrentCCG

I agree with you Keith, the biggest sticking point is where are all these GPs?
It promises wonderful things to suggest this way of working, and I would love the communication barriers between specialties to be overcome and integrated care to benefit our patients; however, it is unrealistic to imagine the model can be transplanted from the USA to the UK unless there is a massive drive to make general practice a more attractive career option with the attached *long term* funding that is needed.

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