Current practice
Scenario 1
Scenario 2
Total number of patients diagnosed
164,763 29,661
164,763 29,661
164,763 29,661
Total number of patients referred to specialist care GP appointments per-patient pre-referral
3
1
2
Total number of appointments
88,983.02
29,661.01
59,322.01
Total cost of GP appointments
£2,669,490
£889,830
£1,779,660
Potential cost savings
N/A
£1,779,660
£889,830
Eczema There is less established literature on atopic eczema in England, especially in relation to the cohorts of people with more severe disease who are most likely to require referral to specialist care. For example, there is an absence of published data on the number of appointments that people with severe atopic eczema are likely to have before they are referred. However, research indicates that people with severe atopic eczema typically attend significantly more appointments across primary and secondary care than those with less severe symptoms – attending on average 18.76 general practice appointments each year. 44 This leads to a considerable utilisation of resources in relation to both primary care capacity and funding. The table below sets out a series of calculations on the potential impact of reducing primary care appointments for people with severe atopic eczema, in line with the recommendations made by NHS England for improved supported self-management and referral optimisation. Alongside an illustration of current practice, the table sets out two scenarios: 1. Reducing the number of appointments by almost three quarters – it is possible that implementing a comprehensive range of supported self-management and referral optimisation solutions could enable a significant reduction in utilisation. 2. Reducing the number of appointments by half – it is conceivable that either a) a considerable number of appointments will continue to be appropriate for some patients or b) that it will not be possible for all areas of the country to implement self-management or referral optimisation solutions in full, reducing their impact.
Current practice
Scenario 1
Scenario 2
Total number of patients with severe atopic eczema
9,564
9,564
9,564
Average number of GP appointments per patient Estimated total annual total number of GP appointments
18.76
5
9
179,421
47,820
86,076
Total cost of GP appointments
£5,382,619
£1,434,600
£2,582,280
Potential cost saving
N/A
£3,948,019
£2,800,339
18
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