Draft HIU - The Middlewood Partnership

BDP VHIU Project | Impact Summary :root { --dark-green: #296605; --medium-green: #4d821c; --pale-green: #bfdaa8; --lightest-green: #e8f4e0; --nhs-blue: #005eb8; --dark-blue: #003d7a; --warm-white: #fafdf8; --text-dark: #1a2e0a; --text-muted: #5a6b4a; }

        * {
            margin: 0;
            padding: 0;
            box-sizing: border-box;
        }
        html {
            scroll-behavior: smooth;
        }
        body {
            font-family: 'DM Sans', -apple-system, BlinkMacSystemFont, sans-serif;
            background: var(--warm-white);
            color: var(--text-dark);
            line-height: 1.6;
            overflow-x: hidden;
        }
        /* Navigation */
        nav {
            position: fixed;
            top: 0;
            left: 0;
            right: 0;
            z-index: 1000;
            background: rgba(255, 255, 255, 0.95);
            backdrop-filter: blur(20px);
            border-bottom: 1px solid rgba(77, 130, 28, 0.1);
            padding: 1rem 2rem;
            display: flex;
            justify-content: space-between;
            align-items: center;
            transition: all 0.3s ease;
        }
        nav.scrolled {
            box-shadow: 0 4px 30px rgba(41, 102, 5, 0.1);
        }
        .nav-logo {
            display: flex;
            align-items: center;
            gap: 0.75rem;
        }
        .nav-logo-icon {
            width: 45px;
            height: 45px;
            background: linear-gradient(135deg, var(--dark-green), var(--medium-green));
            border-radius: 50%;
            display: flex;
            align-items: center;
            justify-content: center;
            color: white;
            font-weight: 700;
            font-size: 0.9rem;
        }
        .nav-logo-text {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 1.1rem;
            color: var(--dark-green);
        }
        .nav-links {
            display: flex;
            gap: 2rem;
            list-style: none;
        }
        .nav-links a {
            text-decoration: none;
            color: var(--text-muted);
            font-size: 0.9rem;
            font-weight: 500;
            transition: color 0.3s ease;
            position: relative;
        }
        .nav-links a::after {
            content: '';
            position: absolute;
            bottom: -4px;
            left: 0;
            width: 0;
            height: 2px;
            background: var(--medium-green);
            transition: width 0.3s ease;
        }
        .nav-links a:hover {
            color: var(--dark-green);
        }
        .nav-links a:hover::after {
            width: 100%;
        }
        /* Hero Section */
        .hero {
            min-height: 100vh;
            background: linear-gradient(135deg, var(--dark-green) 0%, var(--medium-green) 50%, var(--pale-green) 100%);
            position: relative;
            display: flex;
            align-items: center;
            overflow: hidden;
        }
        .hero::before {
            content: '';
            position: absolute;
            top: 0;
            left: 0;
            right: 0;
            bottom: 0;
            background: url("data:image/svg+xml,%3Csvg width='60' height='60' viewBox='0 0 60 60' xmlns='http://www.w3.org/2000/svg'%3E%3Cg fill='none' fill-rule='evenodd'%3E%3Cg fill='%23ffffff' fill-opacity='0.05'%3E%3Cpath d='M36 34v-4h-2v4h-4v2h4v4h2v-4h4v-2h-4zm0-30V0h-2v4h-4v2h4v4h2V6h4V4h-4zM6 34v-4H4v4H0v2h4v4h2v-4h4v-2H6zM6 4V0H4v4H0v2h4v4h2V6h4V4H6z'/%3E%3C/g%3E%3C/g%3E%3C/svg%3E");
            opacity: 0.5;
        }
        .hero-content {
            max-width: 1400px;
            margin: 0 auto;
            padding: 8rem 4rem 4rem;
            display: grid;
            grid-template-columns: 1fr 1fr;
            gap: 4rem;
            align-items: center;
            position: relative;
            z-index: 1;
        }
        .hero-text h1 {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: clamp(2.5rem, 5vw, 4rem);
            color: white;
            margin-bottom: 0.5rem;
            line-height: 1.1;
            animation: fadeInUp 0.8s ease-out;
        }
        .hero-text .subtitle {
            font-size: 1.5rem;
            color: rgba(255, 255, 255, 0.9);
            font-style: italic;
            margin-bottom: 2rem;
            animation: fadeInUp 0.8s ease-out 0.1s both;
        }
        .hero-insight {
            background: rgba(255, 255, 255, 0.15);
            backdrop-filter: blur(10px);
            border-radius: 20px;
            padding: 2rem;
            border: 1px solid rgba(255, 255, 255, 0.2);
            animation: fadeInUp 0.8s ease-out 0.2s both;
        }
        .hero-insight h2 {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 1.3rem;
            color: white;
            margin-bottom: 1rem;
        }
        .hero-insight p {
            color: rgba(255, 255, 255, 0.95);
            font-size: 1.05rem;
            line-height: 1.7;
        }
        .hero-visual {
            display: flex;
            flex-direction: column;
            gap: 1.5rem;
            animation: fadeInRight 1s ease-out 0.3s both;
        }
        .stat-cards {
            display: grid;
            grid-template-columns: repeat(3, 1fr);
            gap: 1rem;
        }
        .stat-card {
            background: white;
            border-radius: 16px;
            padding: 1.5rem;
            text-align: center;
            box-shadow: 0 20px 60px rgba(0, 0, 0, 0.15);
            transform: translateY(0);
            transition: transform 0.3s ease, box-shadow 0.3s ease;
        }
        .stat-card:hover {
            transform: translateY(-5px);
            box-shadow: 0 30px 80px rgba(0, 0, 0, 0.2);
        }
        .stat-card .number {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 2.5rem;
            color: var(--dark-green);
            line-height: 1;
            margin-bottom: 0.5rem;
        }
        .stat-card .label {
            font-size: 0.85rem;
            color: var(--text-muted);
            font-weight: 500;
        }
        .hero-tagline {
            text-align: center;
            color: white;
            font-size: 1.2rem;
            font-weight: 500;
            padding: 1rem 2rem;
            background: rgba(0, 0, 0, 0.2);
            border-radius: 100px;
            backdrop-filter: blur(5px);
        }
        /* Section Styles */
        section {
            padding: 6rem 4rem;
            max-width: 1400px;
            margin: 0 auto;
        }
        .section-header {
            text-align: center;
            margin-bottom: 4rem;
        }
        .section-header h2 {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: clamp(2rem, 4vw, 3rem);
            color: var(--dark-green);
            margin-bottom: 1rem;
        }
        .section-header p {
            font-size: 1.15rem;
            color: var(--text-muted);
            max-width: 700px;
            margin: 0 auto;
        }
        /* Understanding Data Section */
        .data-section {
            background: var(--lightest-green);
            border-radius: 40px;
            margin: 2rem;
            padding: 4rem;
        }
        .comparison-grid {
            display: grid;
            grid-template-columns: 1fr 1fr;
            gap: 2rem;
            margin-top: 3rem;
        }
        .comparison-card {
            background: white;
            border-radius: 24px;
            padding: 2.5rem;
            box-shadow: 0 10px 40px rgba(41, 102, 5, 0.08);
            position: relative;
            overflow: hidden;
        }
        .comparison-card.headline {
            border: 2px solid #e0e0e0;
        }
        .comparison-card.underlying {
            border: 2px solid var(--medium-green);
            background: linear-gradient(135deg, white 0%, var(--lightest-green) 100%);
        }
        .comparison-card h3 {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 1.4rem;
            margin-bottom: 0.5rem;
        }
        .comparison-card.headline h3 {
            color: #666;
        }
        .comparison-card.underlying h3 {
            color: var(--dark-green);
        }
        .comparison-card .patient-count {
            font-size: 0.95rem;
            color: var(--text-muted);
            margin-bottom: 2rem;
        }
        .metric-row {
            display: flex;
            justify-content: space-between;
            align-items: center;
            padding: 1rem 0;
            border-bottom: 1px solid rgba(0, 0, 0, 0.05);
        }
        .metric-row:last-child {
            border-bottom: none;
        }
        .metric-label {
            font-weight: 600;
            color: var(--text-dark);
        }
        .metric-values {
            display: flex;
            align-items: center;
            gap: 1rem;
        }
        .metric-before, .metric-after {
            padding: 0.5rem 1rem;
            border-radius: 8px;
            font-weight: 600;
        }
        .metric-before {
            background: #f5f5f5;
            color: #666;
        }
        .metric-after {
            background: var(--pale-green);
            color: var(--dark-green);
        }
        .metric-after.negative {
            background: #ffe5e5;
            color: #c00;
        }
        .metric-change {
            font-size: 0.85rem;
            font-weight: 700;
        }
        .metric-change.positive {
            color: var(--dark-green);
        }
        .metric-change.neutral {
            color: #999;
        }
        .arrow {
            color: var(--medium-green);
            font-size: 1.5rem;
        }
        .comparison-verdict {
            margin-top: 1.5rem;
            padding: 1rem;
            border-radius: 12px;
            text-align: center;
            font-weight: 600;
        }
        .comparison-card.headline .comparison-verdict {
            background: #f5f5f5;
            color: #888;
        }
        .comparison-card.underlying .comparison-verdict {
            background: var(--dark-green);
            color: white;
        }
        .outlier-note {
            background: white;
            border-left: 4px solid var(--nhs-blue);
            padding: 1.5rem 2rem;
            margin-top: 2rem;
            border-radius: 0 12px 12px 0;
            box-shadow: 0 5px 20px rgba(0, 0, 0, 0.05);
        }
        .outlier-note strong {
            color: var(--nhs-blue);
        }
        /* Success Section */
        .success-section {
            background: white;
        }
        .success-content {
            display: grid;
            grid-template-columns: 1.2fr 1fr;
            gap: 4rem;
            align-items: start;
        }
        .trajectory-chart {
            background: linear-gradient(180deg, var(--lightest-green) 0%, white 100%);
            border-radius: 24px;
            padding: 2.5rem;
            position: relative;
        }
        .trajectory-chart h3 {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 1.5rem;
            color: var(--dark-green);
            margin-bottom: 2rem;
        }
        .chart-container {
            height: 300px;
            position: relative;
            margin: 2rem 0;
        }
        .chart-svg {
            width: 100%;
            height: 100%;
        }
        .chart-legend {
            display: flex;
            gap: 2rem;
            justify-content: center;
            margin-top: 1rem;
        }
        .legend-item {
            display: flex;
            align-items: center;
            gap: 0.5rem;
            font-size: 0.9rem;
        }
        .legend-dot {
            width: 12px;
            height: 12px;
            border-radius: 50%;
        }
        .legend-dot.expected {
            background: #999;
        }
        .legend-dot.actual {
            background: var(--medium-green);
        }
        .key-finding {
            background: white;
            border-radius: 24px;
            padding: 2.5rem;
            box-shadow: 0 15px 50px rgba(41, 102, 5, 0.1);
        }
        .key-finding h3 {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 1.3rem;
            color: var(--dark-green);
            margin-bottom: 1.5rem;
            display: flex;
            align-items: center;
            gap: 0.75rem;
        }
        .key-finding h3::before {
            content: '★';
            color: var(--medium-green);
        }
        .finding-highlight {
            background: linear-gradient(135deg, var(--dark-green), var(--medium-green));
            color: white;
            padding: 2rem;
            border-radius: 16px;
            margin: 1.5rem 0;
        }
        .finding-highlight .big-number {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 3.5rem;
            line-height: 1;
        }
        .finding-highlight .description {
            font-size: 1.1rem;
            margin-top: 0.5rem;
            opacity: 0.95;
        }
        .swing-stat {
            display: flex;
            align-items: center;
            gap: 1rem;
            padding: 1rem;
            background: var(--lightest-green);
            border-radius: 12px;
            margin-top: 1rem;
        }
        .swing-stat .icon {
            font-size: 2rem;
        }
        .swing-stat .text {
            font-size: 0.95rem;
            color: var(--text-dark);
        }
        .swing-stat .text strong {
            color: var(--dark-green);
        }
        /* Outcomes Grid */
        .outcomes-grid {
            display: grid;
            grid-template-columns: repeat(2, 1fr);
            gap: 2rem;
            margin-top: 3rem;
        }
        .outcome-card {
            background: white;
            border-radius: 24px;
            padding: 2rem;
            box-shadow: 0 10px 40px rgba(0, 0, 0, 0.06);
            text-align: center;
        }
        .outcome-card h4 {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 1.2rem;
            color: var(--dark-green);
            margin-bottom: 1.5rem;
        }
        .donut-chart {
            width: 180px;
            height: 180px;
            margin: 0 auto 1.5rem;
            position: relative;
        }
        .donut-chart svg {
            transform: rotate(-90deg);
        }
        .donut-chart .center-text {
            position: absolute;
            top: 50%;
            left: 50%;
            transform: translate(-50%, -50%);
            text-align: center;
        }
        .donut-chart .percentage {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 2.5rem;
            color: var(--dark-green);
            line-height: 1;
        }
        .donut-chart .label {
            font-size: 0.8rem;
            color: var(--text-muted);
        }
        .outcome-detail {
            font-size: 0.9rem;
            color: var(--text-muted);
            padding: 0.75rem;
            background: var(--lightest-green);
            border-radius: 8px;
        }
        /* Financial Section */
        .financial-section {
            background: linear-gradient(180deg, var(--dark-green) 0%, #1a4a02 100%);
            color: white;
            border-radius: 40px;
            margin: 2rem;
            position: relative;
            overflow: hidden;
        }
        .financial-section::before {
            content: '';
            position: absolute;
            top: 0;
            right: 0;
            width: 50%;
            height: 100%;
            background: url("data:image/svg+xml,%3Csvg width='100' height='100' viewBox='0 0 100 100' xmlns='http://www.w3.org/2000/svg'%3E%3Ccircle cx='50' cy='50' r='40' fill='none' stroke='%23ffffff' stroke-opacity='0.05' stroke-width='1'/%3E%3C/svg%3E");
            opacity: 0.5;
        }
        .financial-section .section-header h2 {
            color: white;
        }
        .financial-section .section-header p {
            color: rgba(255, 255, 255, 0.8);
        }
        .financial-flow {
            display: flex;
            justify-content: center;
            align-items: center;
            gap: 2rem;
            margin: 3rem 0;
            flex-wrap: wrap;
            position: relative;
            z-index: 1;
        }
        .financial-box {
            padding: 2rem 3rem;
            border-radius: 20px;
            text-align: center;
            min-width: 200px;
        }
        .financial-box.investment {
            background: rgba(255, 255, 255, 0.1);
            border: 2px solid rgba(255, 255, 255, 0.3);
        }
        .financial-box.savings {
            background: rgba(255, 255, 255, 0.15);
            border: 2px solid rgba(255, 255, 255, 0.4);
        }
        .financial-box.benefit {
            background: white;
            color: var(--dark-green);
            transform: scale(1.1);
            box-shadow: 0 20px 60px rgba(0, 0, 0, 0.3);
        }
        .financial-box .label {
            font-size: 0.9rem;
            text-transform: uppercase;
            letter-spacing: 0.1em;
            margin-bottom: 0.5rem;
            opacity: 0.9;
        }
        .financial-box .amount {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 2.5rem;
            line-height: 1;
        }
        .financial-box.benefit .label {
            color: var(--medium-green);
        }
        .financial-arrow {
            font-size: 2rem;
            color: rgba(255, 255, 255, 0.5);
        }
        .roi-stats {
            display: grid;
            grid-template-columns: repeat(3, 1fr);
            gap: 2rem;
            margin-top: 3rem;
            position: relative;
            z-index: 1;
        }
        .roi-stat {
            text-align: center;
            padding: 2rem;
            background: rgba(255, 255, 255, 0.1);
            border-radius: 20px;
            backdrop-filter: blur(10px);
        }
        .roi-stat .icon {
            font-size: 2.5rem;
            margin-bottom: 1rem;
        }
        .roi-stat .value {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 3rem;
            color: var(--pale-green);
            line-height: 1;
        }
        .roi-stat .desc {
            font-size: 0.95rem;
            margin-top: 0.5rem;
            opacity: 0.9;
        }
        .what-counted {
            display: grid;
            grid-template-columns: 1fr 1fr;
            gap: 2rem;
            margin-top: 3rem;
            position: relative;
            z-index: 1;
        }
        .counted-box {
            padding: 2rem;
            border-radius: 20px;
        }
        .counted-box.yes {
            background: rgba(255, 255, 255, 0.1);
        }
        .counted-box.no {
            background: rgba(0, 0, 0, 0.2);
        }
        .counted-box h4 {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 1.2rem;
            margin-bottom: 1rem;
            display: flex;
            align-items: center;
            gap: 0.5rem;
        }
        .counted-box ul {
            list-style: none;
        }
        .counted-box li {
            padding: 0.5rem 0;
            font-size: 0.95rem;
            opacity: 0.9;
            display: flex;
            align-items: center;
            gap: 0.5rem;
        }
        .counted-box li::before {
            content: '•';
            color: var(--pale-green);
        }
        /* Ask Section */
        .ask-section {
            background: var(--lightest-green);
            border-radius: 40px;
            margin: 2rem;
        }
        .ask-highlights {
            display: flex;
            justify-content: center;
            gap: 1rem;
            flex-wrap: wrap;
            margin-bottom: 3rem;
        }
        .highlight-pill {
            display: flex;
            align-items: center;
            gap: 0.5rem;
            padding: 0.75rem 1.5rem;
            background: white;
            border-radius: 100px;
            font-weight: 500;
            color: var(--dark-green);
            box-shadow: 0 4px 15px rgba(41, 102, 5, 0.1);
        }
        .highlight-pill .check {
            color: var(--medium-green);
            font-weight: 700;
        }
        .capacity-comparison {
            display: grid;
            grid-template-columns: 1fr 1fr;
            gap: 2rem;
        }
        .model-card {
            background: white;
            border-radius: 24px;
            padding: 2.5rem;
            position: relative;
            overflow: hidden;
        }
        .model-card.current {
            border: 2px solid #ddd;
        }
        .model-card.proposed {
            border: 2px solid var(--medium-green);
            box-shadow: 0 20px 60px rgba(41, 102, 5, 0.15);
        }
        .model-card.proposed::before {
            content: 'RECOMMENDED';
            position: absolute;
            top: 1rem;
            right: -2rem;
            background: var(--medium-green);
            color: white;
            padding: 0.25rem 3rem;
            font-size: 0.7rem;
            font-weight: 700;
            letter-spacing: 0.1em;
            transform: rotate(45deg);
        }
        .model-card h3 {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 1.4rem;
            margin-bottom: 1.5rem;
        }
        .model-card.current h3 {
            color: #666;
        }
        .model-card.proposed h3 {
            color: var(--dark-green);
        }
        .model-diagram {
            display: flex;
            flex-direction: column;
            gap: 1rem;
            margin: 1.5rem 0;
        }
        .diagram-row {
            display: flex;
            gap: 0.5rem;
            flex-wrap: wrap;
        }
        .diagram-item {
            padding: 0.5rem 1rem;
            border-radius: 8px;
            font-size: 0.85rem;
            font-weight: 500;
        }
        .diagram-item.gp {
            background: var(--nhs-blue);
            color: white;
        }
        .diagram-item.task {
            background: #f0f0f0;
            color: #666;
        }
        .diagram-item.support {
            background: var(--pale-green);
            color: var(--dark-green);
        }
        .model-outcome {
            padding: 1rem;
            border-radius: 12px;
            text-align: center;
            font-weight: 600;
            margin-top: 1.5rem;
        }
        .model-card.current .model-outcome {
            background: #f5f5f5;
            color: #888;
        }
        .model-card.proposed .model-outcome {
            background: var(--dark-green);
            color: white;
        }
        .supporting-stats {
            display: grid;
            grid-template-columns: repeat(3, 1fr);
            gap: 1rem;
            margin-top: 2rem;
            padding: 1.5rem;
            background: var(--lightest-green);
            border-radius: 16px;
        }
        .support-stat {
            text-align: center;
        }
        .support-stat .value {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 1.5rem;
            color: var(--dark-green);
        }
        .support-stat .label {
            font-size: 0.8rem;
            color: var(--text-muted);
        }
        /* Footer */
        footer {
            background: var(--dark-green);
            color: white;
            padding: 3rem 4rem;
            text-align: center;
        }
        footer .logo-text {
            font-family: 'DM Serif Display', Georgia, serif;
            font-size: 1.5rem;
            margin-bottom: 1rem;
        }
        footer p {
            opacity: 0.8;
            font-size: 0.9rem;
        }
        /* Animations */
        @keyframes fadeInUp {
            from {
                opacity: 0;
                transform: translateY(30px);
            }
            to {
                opacity: 1;
                transform: translateY(0);
            }
        }
        @keyframes fadeInRight {
            from {
                opacity: 0;
                transform: translateX(30px);
            }
            to {
                opacity: 1;
                transform: translateX(0);
            }
        }
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BDP
            Care Community
        

Overview
The Data
Why It Works
Financial Case
The Ask





BDP VHIU Project
Impact Summary

The Core Insight
For frail elderly patients with multiple conditions, standing still represents success. National data shows this population typically experiences 8-12% annual increases in emergency care use. Our 18% reduction isn't just an improvement—it's a reversal of expected decline.





85+
Average Age


4-6
Long Term Conditions


Top 2%
Risk Stratification



                    Proactive, personalised support for BDP's most complex patients
                





Understanding the Data
Early in the programme, the data showed a clear reduction in A&E attendances and emergency admissions. Over time, headline figures appeared to flatten—but the underlying story reveals sustained impact.

The Outlier Effect


Headline View
All 137 Patients

                    A&E Attendances

                        Before: 248

                        →

                        After: 251

                        (+1%)
                    


                    Emergency Admissions

                        Before: 115

                        →

                        After: 107

                        (-7%)
                    

Appears flat — minimal improvement


Underlying Picture
132 Patients (excluding 5 with unavoidable hospital use)

                    A&E Attendances

                        Before: 217

                        →

                        After: 177

                        (-18%)
                    


                    Emergency Admissions

                        Before: 92

                        →

                        After: 75

                        (-18%)
                    

Clear sustained reduction ✓



            5 patients with active cancer and similar conditions required clinically appropriate hospital care. Their activity is tracked separately — not hidden. Their hospital use was appropriate and unavoidable, reflecting the reality of caring for people with advanced illness rather than failure of community care.
        



Why Standing Still Means Success
Traditional healthcare metrics assume improvement means reduction. But for frail elderly patients with progressive conditions, the natural trajectory is increased emergency care use year-on-year.



Why 'Standing Still' Represents Success

                    
                        
                        
                        
                        
                        High
                        Low
                        Emergency Activity
                        
                        0
                        6
                        12 months
                        
                        
                        Expected
                        (8-12% increase)
                        
                        
                        BDP Cohort
                        (18% reduction)
                        
                        
                        Programme
                        Impact
                        
                        
                        
                    
                



                        Expected trajectory (without intervention)
                    


                        Actual BDP HIU cohort
                    



Key Finding

18%
reduction in both A&E attendances and emergency admissions

Against an expected 8-12% annual increase, the BDP HIU cohort achieved an 18% reduction. This represents a swing of 26-30 percentage points against the expected trajectory.

                    📊

                    26-30 percentage points better than expected trajectory
                


Patient Outcomes: 132 Patients Over 12 Months


A&E Attendances

                    
                        
                        
                    

64%
stable or improved



                    60% reduced or no change (79 patients)

                    34% increased (44 patients)
                


Emergency Admissions

                    
                        
                        
                    

76%
stable or improved



                    76% reduced or no change (93 patients)

                    24% increased (30 patients)
                



            KEY TAKEAWAY: 3 in 4 patients showed reduced or stable emergency admissions. In a population where decline is expected, maintaining stability is a meaningful clinical outcome. Reduction is exceptional.
        



Programme Value: The Financial Case
Beyond clinical outcomes, the programme demonstrates clear financial value using NHS reference costs and conservative estimates.



Investment
£46,015

→

Gross Savings
£96,452

→

Net Benefit
£50,437




💷
£2.10
return for every £1 invested


🏥
40
A&E attendances avoided


🛏️
17
emergency admissions avoided




✓ What's Counted

A&E attendances avoided (£165 each)
Emergency admissions avoided (£2,300 each)
Based on NHS National Tariff reference costs


✗ What's NOT Counted

Reduced GP appointments
Fewer 111/999 calls
Medication savings from deprescribing
Improved quality of life



            This suggests the model is not only clinically valuable but also cost-effective, despite working at the most complex end of the spectrum.
        



The Ask: Continued Investment


✓ The model works — 18% reduction, £2.10 return per £1
✓ Context matters — stability is success in advanced frailty
✓ Investment unlocks capacity — team support could double throughput

Unlocking Capacity: The Case for Team-Based HIU Care


Current Model


                        Dr King — 4 sessions/week
                    

                        Initial assessments (45-60 mins)

                        Follow-up calls
                    

                        Care coordination

                        MDT liaison
                    


                    121 patients seen in 8 months

                    Too many follow-ups means less new patient reviews
                


Proposed Model with Support Staff


                        Dr King & Team
                    

                        Initial Complex Assessments

                        Clinical Decisions
                    

                        Follow-up contacts

                        Social prescribing links

                        Telephone check-ins
                    


                    Potential to double new patient assessments

                    Every follow-up handled by support staff = one more complex patient Dr King can assess
                




3.1
Average follow-up contacts per patient


375
121 patients × 3.1 = total follow-up contacts


60+
Hours of GP time freed annually




                Continued investment, particularly with stronger multidisciplinary support around the GP role, is likely to increase both clinical benefit and system value over time. Expanding the team would enable more interventions, increase capacity, and result in greater overall savings for the system.
            



BDP Care Community
Bollington, Disley and Poynton Care Community — December 2025

    
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