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Is your GP surgery one of the 50%?

04 January 2016

Age UK Sheffield’s pioneering Integrated Care Programme (ICP) has seen increased referrals from GPs across the city. More than 50% of GP surgeries have referred patients and are therefore helping people over 50 regain or maintain their independence. Is your surgery one of those which has – or hasn’t?


The ICP is a ground-breaking national Age UK project which is being piloted in eight areas across England. In Sheffield it is funded jointly by Age UK and NHS Sheffield Clinical Commissioning Group.

The aim of the programme is to reduce unplanned hospital admissions or other calls on statutory health and social care services.

Programme participants are identified by GPs in consultation with Age UK Sheffield, and selected based on a combination of their long-term health conditions, previous hospital admissions, and risk of future unplanned admission. The criteria were slightly relaxed in November 2015, meaning patients who weren’t previously eligible for the programme might now be accepted.

Age UK Sheffield Independent Living Co-ordinators work individually with each referral for up to 12 weeks, helping patients to live independently, manage their health conditions, and improve their health and wellbeing.

We complete Patient Activation Measure (PAM) questionnaires before and after intervention, and share our holistic assessment so it can be included in care plans. Weekly updates are provided to GPs using NHS secure e-mail and we can attend MDT meetings to discuss patients on the programme.

Evidence based on the success of this project in Cornwall has directly shown a reduction in unplanned hospital admissions, as well as unnecessary GP appointments, which have subsequently led to reduced health and social care costs.

If you have a patient who may be suitable for the ICP please click here to fill in the attached form or phone us on 0114 250 2850.

For more details about the initiative, please contact Teresa Barker at