More doctors on the ground: multi-specialist clinics always open

The health reform, which became law on 1 January, gives an important role to GPs and to primary care paediatricians. They will not only be in the front line in the territory, but they will become a cornerstone of chronic and specialised healthcare.

But how? “We will have to coordinate with the health protection agencies to identify clinics in each of the former local health authority districts,” explained Dr Aurelio Sessa, a GP. “The model entails encouraging the building of network systems, where general and specialised physicians and paediatricians work together. We foresee that, within six months, we will be able to set up this service, where it will be possible to work also with basic diagnostic equipment available to carry out initial tests. This service will relieve the workload of the casualty departments and wards.”

The future “out-patient departments”, which will be called “PREST”, will bring a number of specialties together on the same premises, which GPs will be able to turn to, but also a blood testing centre, an ultrasound and an x-ray machine, to enable the initial investigations to be carried out.

Moreover, there will always be medical and nursing personnel available, thanks to the introduction of CREGs (chronic related groups), which will constitute a new form of networking between general physicians and casualty personnel in the same district, and where it will always be possible to reach health personnel (doctors and nurses) in the evenings and on Sundays and public holidays. “Already in surgeries, there is always a doctor on duty on Saturday morning, from 8 a.m. to midday. The evolution of the CREGs will result in the continuous provision of first level healthcare,” Dr Sessa explained.

The new duties of the general practitioners include the signing of an agreement with chronic patients to take on their overall care. To limit the cost of chronic cases (alone, these take up 70% of the regional health expenditure) a procedure will be created of check-ups and tests to prevent the disease from becoming acute and prevent complications. In this way, visits to casualty departments and hospitals will be limited, resulting in an improvement in the quality of life. In the agreement, it is expected that general practitioners and specialists will introduce the patient into a programme that will be managed by local hospital units, centres specialised in the treatment of chronic cases (in Varese Province, the trial opening of a centre in Somma Lombardo is planned).

Lombardy Region have decided to allocate up to €900,000 to cover the cost of this new healthcare service, to which €880,000 has been added to increase the Saturday morning opening of medical out-patient departments.