WordPress database error: [Duplicate entry '0' for key 'PRIMARY']
INSERT INTO harvey_2022_actionscheduler_actions ( `hook`, `status`, `scheduled_date_gmt`, `scheduled_date_local`, `schedule`, `group_id`, `priority`, `args` ) SELECT 'action_scheduler/migration_hook', 'pending', '2025-08-04 22:08:16', '2025-08-04 23:08:16', 'O:30:\"ActionScheduler_SimpleSchedule\":2:{s:22:\"\0*\0scheduled_timestamp\";i:1754345296;s:41:\"\0ActionScheduler_SimpleSchedule\0timestamp\";i:1754345296;}', 1, 10, '[]' FROM DUAL WHERE ( SELECT NULL FROM DUAL ) IS NULL

Using A Long-Term Conditions Register To Help Care Planning At Weybridge PCT – Oberoi Consulting
Oberoi Consulting

Using A Long-Term Conditions Register To Help Care Planning At Weybridge PCT

Using A Long-Term Conditions Register To Help Care Planning At Weybridge PCT

We worked with Weybridge PCT to support three pilot practices in establishing a long-term conditions register in order to support long term care planning.

We devised searches using the existing GP clinical system and integrated data on prescribing costs over a 12-month period for each patient and PARR scores (Patients At Risk of Re-admission) data where available.

The resulting data was formatted into a simple and workable spreadsheets containing all patients with multiple diseases (as specified by the PCC).

Outcomes:
  • By combining the PARR Scores with the number of disease registers, it was possible to divide the large number of patients initially identified into manageable cohorts.
  • A group of patients were identified as a priority for review as they were found to be on multiple disease registers.
  • The spreadsheets helped with care planning to reduce the risk of hospital re-admittance.

The data provided by the audit process gave clinicians a holistic patient profile that enabled informed clinical interventions.

Request full case study from Oberoi by email: admin@oberoi-consulting.com
by phone: 01332 224 251, or by using the contact form below.

Have a Question?

Please feel free to drop us an email

Contact Us