The Public Accounts Committee report warns that services for patients are likely to suffer following the collapse of an £800 million contract to provide older people's and adult community services.
Since May 2016 more than 600 patients who would have been admitted into the Cumberland Infirmary from the Accident and Emergency department, have been able to go home thanks to the Home First service. 350 of these patients have received additional support from the team.
The Home First team work with patients as soon as they come through the door in Accident and Emergency department, (A&E), to make sure that if discharge is possible the most appropriate therapy and support is available for them to go home.
The team is made up of health professionals from North Cumbria University Hospitals NHS Trust, Cumbria Partnership NHS Foundation Trust as well as Cumbria County Council and the voluntary sector. The team comprises of Occupational Therapists and Physiotherapists based in A&E who work with patients to facilitate safe and timely discharge where appropriate.
104 older people were interviewed, exploring their experiences of emergency admissions. The research focused on whether the older people felt it was appropriate to be admitted to hospital and whether they thought anything could have prevented their admission.
45 surveys were received back from GPs or hospital doctors of the older people in the study. The study also involved interviews or focus groups with 47 health and social care professionals. Birmingham researchers believe this may be the first study in the UK (and possibly internationally) to estimate a rate of ‘inappropriate admissions’ from the perspective of older people.
An end to the standard 10-minute GP consultation to allow family doctors to spend more time with patients with complex needs is core to the Royal College of GPs' vision for the future of general practice.It states that by 2030 face-to-face GP consultations will be at least 15 minutes, with longer for those patients who need it.
The American Hospital Association 2016 Committee on Research was charged with exploring what the next generation of community health may look like as hospitals redefine themselves to keep pace with the changing health care landscape. The committee released this work in the form of a report, Next Generation of Community Health.
The number of people with multiple long-term conditions, known as multimorbidity, is rising internationally, putting increased pressure on health care systems, including the NHS.
This study updates a previous scoping review published by the National Institute for Health Research (NIHR) in 2006 (Roland M, McDonald R, Sibbald B. Outpatient Services and Primary Care: A Scoping Review of Research Into Strategies For Improving Outpatient Effectiveness and Efficiency. Southampton: NIHR Trials and Studies Coordinating Centre; 2006) and focuses on strategies to improve the effectiveness and efficiency of outpatient services.
The service ‘Advice and Guidance’ offers the opportunity for GPs across Morecambe Bay to hold a secure electronic ‘conversation’ with a hospital specialist to obtain real time advice about a patient’s condition. This can often enable a patient to be managed under the care of their local GP.
As part of Better Care Together, Cumbria Health on Call (CHOC) has created a short film introducing the new virtual out of hours GP appointments that can be offered by a state of the art video link between Millom Community Hospital and Cumbria Health on Call (CHOC) headquarters in Carlisle.
This development for patients in Millom is thanks to work done within the Millom Alliance including a partnership between Better Care Together and Cumbria Health on Call (CHOC).
The system offers the opportunity for GPs to seek advice via an electronic “conversation” with a hospital consultant on a patient where they have a query.
Figures released covering the last financial year between April 2015 and March 2016 show that of the 1,919 “conversations” begun by GPs to specialists (that would have previously been a direct referral to hospital for an outpatient appointment.)
655 (34%) patients were managed under the care of the GP with advice from a specialist.
In complex health systems, the highest quality of care occurs when different elements of the system are joined up in a transparent way in order to meet patients’ needs. In a primary-care focused system such as in the UK, the majority of care for children and young people (CYP) is provided in primary care, while most specialist expertise resides in secondary care organisations. Pathways for both acute care and long-term conditions must therefore necessarily cross institutional borders, often multiple times. This can be a source of adverse outcomes and poor patient experience. To read the full article, log in using your NHS OpenAthens details.
A new partnership of healthcare providers, including AWP, has been selected as the preferred bidder to deliver community health services for children and young people. The services will run in Bristol, South Gloucestershire and North Somerset and are due to begin in April 2017.
The services will include health visiting, school nursing, child and adolescent mental health (CAMHS), speech and language therapy, occupational therapy and physiotherapy, community paediatricians, community nursing and a range of dedicated services for vulnerable children including children in care, children with learning disabilities, children with life limiting conditions and children with drug and alcohol problems.
Aim: To determine the feasibility of a nurse-led, primary care-based comprehensive geriatric assessment (CGA) intervention.
To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Last year I was exposed to a hugely positive experience of using digital collaboration tools for the first time within my work in the NHS [adult and older people's community services]
This made me realise that the tools I have routinely and unquestioningly used for years (email and documents) are hopelessly ineffective for the work that I do.
We used Confluence, a wiki (which is a website that anyone can edit), and Slack a group messaging service.
We found that Confluence could replace documents, email and big meetings; Slack could replace email, SMS and small meetings.
Those of us who used the tools, worked more effectively together, saved time and felt better connected. The benefits were that… – we had more productive meetings, as many routine transactions were dealt with outside of the meeting room people could make their voice heard without having to attend face-to-face meetings and could participate in discussions at times which suited them – we reached consensus quicker without having to wait to set up meetings, or to manage complex email discussions – we involved others outside of our usual sphere of influence – we had a permanent and readily visible record of discussions – we received fewer emails, since we could choose to receive updates only about things we were interested in – we could get messages to large numbers of people quickly. Over about a year we managed to get about 250 people using Confluence and about 50 using Slack. Enough to be significant.
The demand for Continuing Healthcare (CHC), packages of care which are arranged and funded solely by the NHS for individuals outside of hospital, is increasing, as is the cost. Staffordshire has been particularly heavily affected, with an average growth rate of 13% over the last three years.
The vision that drove the transformation of the Canterbury health system and that has continued to be its focus is one orientated around care that is people centred, that is connected and that aims not to waste patients’ time: in other words, care that is provided at the right time, by the right person, in the right place.
This study aimed to explore the acceptability of health and wellbeing conversations such as within the third and social economy sector, including their existence without specific training. Open access article - no login required.