By 2030, according to recent estimates, there will be a million more dependent persons. Although Germany, considering the density of doctors, is one of the world’s best-served countries, there are already some rural areas that are underserved. This trend will continue due to demographic factors. Through this ongoing trend today, many services that were previously performed by doctors, are being delegated to the nursing staff.
Thus e.g. The shortage of doctors has led in a small community name Frielendorf (Hesse) for a collaboration between nursing services and primary care physicians. The aim of the project is to relieve GPs through the delegation of medical services. Under the cooperation agreement effective since August, two GPs will assist nursing service staff for home visits (approximately 1,000 patients). The specially trained home visits professionals will monitor the vital signs of patients and record them via checklists, documenting the tools needed to help guide physicians in wound care and medication management, as well as capturing all the drugs that they find in the patients. After each home visit, the information can be faxed to the practices in a timely manner.
For three months, the time spent conducting the home visits are documented and analysed in order to determine the financial need. If initial opinions on the effectiveness of cooperation is positive, a home visit remuneration agreement between the doctors and the nursing service shall be arranged.
By the end of last year, the Gemeinsame Bundesausschuss (G-BA) after three years of consultation adopted a policy which stated that pilot projects and medical activities can be performed by specially trained nurses. The testing phase, according to § 63 Social Code Book V, would apply for eight years. As part of the decision, nurses can treat patients with hypertension, dementia, chronic wounds and diabetes type I and II within test projects. In particular, the policy outlines that qualified nurses can perform the treatment prescribed by the doctor professionally, economically and legally their own. What is also important in the pilot of the G-BA is that nurses, in limited cases, can also prescribe medicines and medical aids.
Even retailers are unaffected by these developments. Many retailers and home care specialists have increasingly focused in recent years on developing their own nurses. The actual care of the patients is still the legal responsibility of care services or caregivers. A true closeness to the patient can thus be achieved only through the care services. The final decision as to which product to use for the patient, too, still lies with the physician.
A pilot project which allows nursing staff to carry treatment of chronic diseases represents real innovation. The model should be transformed into an integral part of the supply system, and therefore must be in the mandated direction budgeting of these people to discuss new products. Even for market development by the manufacturer, these changes bring with them strategically important decisions. Outpatient care services thus become more of a focus for the manufacturer, which can thereby accelerate its direct business – but physicians should not be ignored in the development of this channel. The challenges are to develop this channel and offer the industry new scope in the coming years.