Peripatetic intravenous service for metabolic bone disease: case study in patient centred-care for new NHS.

AbstractObjective:To develop a ‘close to patient’ peripatetic intravenous service (PIVS) for delivery of specialist osteoporosis care in a community setting without increasing cost and with a reduced carbon footprint.Research design and methods:Cost and feasibility of a PIVS for intravenous (i.v.) bisphosphonate treatment were modelled using UK National Health Service costings and then tested in the field for 1 year. Average patient mileage to peripatetic sites was compared with mileage travelled if treated at the base hospital (current practice). The method of travel to hospital (current practice) or peripatetic sites (new study) was ascertained together with patients’ preference for the new or the current system. Peripatetic sites were researched and those with suitable facilities selected. Data for fuel consumption were based on a usage of 1 litre per 14.5 km.Main outcome measures:The main outcome measure was cost comparison between hospital and peripatetic services. Others included patient satisfactio...