Man holding tablet depicting digital health and virtual ward technology

NICE to enable more care closer to home and reduce NHS winter pressures

New draft guidance could reduce pressure on the NHS this winter and cut waiting times for patients, according to the National Institute for Health and Care Excellence (NICE).

The organisation’s new guidelines could mean those with suspected acute respiratory infections (ARIs) are referred to specialist ARI hubs and virtual wards.

While this does not include people with Covid-19, it will encompass those with pneumonia, respiratory viruses, and adult flu.

The prevalence of ARIs has increased since the pandemic and now approximately 220,000 people are diagnosed with pneumonia in England and Wales annually, inviting particular pressure for the NHS in winter when they are more common.

                                                                          Video credit: Canva

The patient pathway

The new guidance dictates that, if a person is suspected to have pneumonia during an online consultation, they should be referred for a face-to-face assessment. This line of action should also be taken if an adequate assessment cannot be made.

At said appointment, healthcare professionals should determine the patient’s ‘CRB65 score’ – something that takes into account age, blood pressure and respiratory rate to help clinicians identify a treatment plan for the patient’s pneumonia.

Ultimately, this will help to ensure patients are directed through to the most appropriate pathway – whether that be in hospital for those who are severely ill, or at home to alleviate pressure by caring for someone via the newly-recommended virtual wards.

Patients who present in places like GP practices and walk-in centres should not be offered microbiological or flu tests to see the viability of antibiotics, according to the guidance. Instead, a clinical assessment should be carried out.

The guidance also recommends health professionals consider using a C-reactive protein test to identify whether to prescribe antibiotics to those without suspected pneumonia.

NHS England’s national medical director, Professor Sir Stephen Powis, said: “I am grateful to NICE for working with us on this new draft guidance which will help inform decisions on where a patient would be best treated while expanding the types of tests and other investigations used to determine the most appropriate treatment”.

Prof Sir Powis further described the guidance as a “real game-changer” for how the NHS can deliver care in the community and something that will be “hugely welcomed” by local health service teams.

The consultation on the new draft guidance will run until Friday 15 September.

Image credit: iStock

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