Hertfordshire has a proud record of working in partnership across health and social care.
In 2014, East and North Hertfordshire CCG, Hertfordshire County Council and the Hertfordshire Care Providers Association (HCPA) successfully secured funding for our Vanguard programme - an NHS England initiative which is part of the New Models of Care programme.
Our aim was to deliver an enhanced model of health and social care to support frail elderly patients, and those with multiple complex long term conditions, in the community, in a planned, proactive and preventative way.
Our Vanguard had many strands – all aimed at keeping our frail, elderly residents healthy and independent and importantly out of A&E and hospital beds.
Research showed that care home residents with complex and long-term conditions are often taken to hospital and sent back the same day. This is not only unsettling for the patient, but adds to the strain on the ambulance service and A&E departments.
Our aim was to help elderly residents living in care homes across east and north Hertfordshire to stay out of hospital, through regular visits from a dedicated GP practice, better trained staff, patient record sharing and expert medication reviews.
Our Care Homes Vanguard has achieved many successes through a variety of projects which now move into ‘business as usual’ for the organisations involved in the project.
The four strands to the project:
- CONFIDENT STAFF – upskilling staff to feel more confident about supporting residents’ health and wellbeing
- MULTI-DISCIPLINARY TEAMS – support and advice from pharmacists, dieticians, geriatricians, mental health professionals, doctors and nurses
- RAPID RESPONSE – Frailty vehicle delivering expert care/support and teams of community nurses, therapists deployed to care homes within 90 minutes
- EFFECTIVE TECHNOLOGY – GP access to comprehensive patient information when they visit them
More information is available here.
Enhanced Care in Care Homes Framework
One of the early successes of the programme was the Medicines Optimisation Project which saw pharmacists conducting detailed medicine reviews with residents. On average, each care home resident takes seven prescribed medicines a day and is more than three times as likely to be admitted to hospital as the general population of over 65-year-olds in the county. Frailty, medication errors and a lack of confidence amongst staff are all contributing factors which result in care home residents being heavy users of emergency and urgent care.
For residents, particularly those living with dementia, every hospital visit has the potential to be confusing and disorientating – particularly as around a quarter of hospital ‘admissions’ are for less than 24 hours.
This infographic summarises the impact of our care home pharmacists as at June 2016: