NHS Arden and Greater East Midlands CSU wins contract to improve outcomes


Risk stratification tool will enhance care for frail and elderly

NHS Arden and Greater East Midlands (GEM) Commissioning Support has secured a contract with Barnet Clinical Commissioning Group (CCG) to provide a risk stratification tool to support the CCG’s integrated care programme for the frail and elderly.

The tool will provide the CCG, local authority, and GPs across Barnet with intelligence about the local frail and elderly population, including identifying those most at risk of attending A&E, being admitted to hospital, or being placed in residential or nursing care.

Using primary and secondary care data, Arden & GEM’s risk stratification tool is underpinned by a sophisticated algorithm to calculate risk, developed by the Johns Hopkins University and used by commercial and research settings worldwide.

The tool can be adapted to suit local needs, enabling GPs to pro-actively target particular patients and providing commissioners with more information about trends and particular conditions.

Hina Naik, head of information services at Arden and GEM, said: “We are delighted to be working with Barnet CCG to provide our proven risk stratification solution.

“We have developed the tool to give GPs and commissioners valuable insight into their local populations, to help support decision making, and improve direct patient care.”

Rather than just focusing on those with established needs, Arden and GEM will be working with Barnet to identify patients who are increasingly likely to need support.

Naik said: “Being able to spot emerging needs gives commissioners the opportunity to anticipate and tackle changes in requirements, including resourcing and skills’ gaps. As a result, services can be targeted more effectively, driving up primary care quality and performance.”

Christa Caton, joint health vommissioner at Barnet CCG, said: “We are looking forward to building a clearer picture of local frail and elderly patients in Barnet.

“The tool will put GP practices in a strong position to provide pro-active care to those who are likely to need more complex health and social care services in the future and will help us to make informed commissioning decisions.”

The tool will be rolled out to 62 GP practices across Barnet from next month, marking the start of a one-year contract worth over £120,000.

Alongside the rollout, Arden and GEM will provide a comprehensive training programme followed by ongoing technical support.

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Delivered as part of Arden & GEM’s leading healthcare business intelligence system, GEMIMA, the tool integrates with GP practices’ clinical systems and is already relied upon by five other CCGs in Leicestershire and Northamptonshire.