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There has been a small population growth to the population of around 260,000, and a few practices' lists have been closed as they do not have the capacity to take on additional patients. The main motivator however is to improve the quality of care for nursing home patients, and related to this, help reduce non-elective care of this group. Currently 10-15% of nursing home patients become non-elective admissions every year.

The PCT are open to new ideas and are considering running a city wide peripatetic service, which would be likely to pay regular visits to patients, using a case management model. Patients would, voluntarily, register with the new service. This would create increased capacity across existing GP practices helping them to further expand and improve the services that they are able to offer to their existing patients.

The PCT are also interested in the idea of the service helping to identify and provide for any training needs within the nursing home industry.

Benefits to nursing home patients include being offered a choice of provider, having a service which is designed to meet their specific needs, increased access to services, and ultimately, better quality of life.

This service will clearly improve patient choice though, importantly, patients maintain the right to remain registered with their existing GP practice or register with the new service which will provide the whole range of general medical services. Plymouth has approximately 1,600 patients who could benefit from this service depending on the uptake of the scheme. The PCT is also interested in potentially offering the service in the future to residential care homes, who look after a maximum total of 2,000 residents.