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Moving healthcare closer to home: case study: Enhanced Rapid Response Service: Kent Community Health NHS Foundation Trust
- Author:
- MONITOR
- Publisher:
- Monitor
- Publication year:
- 2015
- Pagination:
- 4
- Place of publication:
- London
This is one of a suite of case studies designed to increase awareness of schemes to move healthcare closer to home. The Enhanced Rapid Response Service (ERRS) helps patients in crisis avoid a stay in an acute hospital where clinically appropriate. After initial clinical triage, the service assesses the patient in their own home where medical, nursing and therapy support is then given. Important features of the service include leadership by the consultant geriatrician, who manages a team of specialty doctors and enhanced practitioners, and an engagement programme with primary care, the mental health trust, social care and the ambulance trust to boost uptake of the service. (Edited publisher abstract)
Moving healthcare closer to home: summary
- Author:
- MONITOR
- Publisher:
- Monitor
- Publication year:
- 2015
- Pagination:
- 12
- Place of publication:
- London
Summarises the findings of a project examining examples where provision of non-elective care moved from an acute hospital to the community. The Five Year Forward View has encouraged efforts to deliver more healthcare out of acute hospitals and closer to home, with the aim of providing better care for patients, cutting the number of unplanned bed days in hospitals and reducing net costs. Drawing on the lessons from a set of case studies, this analysis shows that: well-designed schemes to move healthcare closer to home can deliver benefits in the long term; it is difficult, however, to cut costs across a local health economy in the short run; and better data and improved pricing would help. The paper is part of a suite of materials developed to support providers and commissioners making decisions about schemes to move healthcare currently provided in acute hospitals to community-based settings. (Edited publisher abstract)
Moving healthcare closer to home: case study: Older Persons Assessment and Liaison team: Ashford and St Peter’s Hospitals NHS Foundation Trust
- Author:
- MONITOR
- Publisher:
- Monitor
- Publication year:
- 2015
- Pagination:
- 6
- Place of publication:
- London
This is one of a suite of case studies designed to increase awareness of schemes to move healthcare closer to home. The Older Persons Assessment and Liaison (OPAL) team provides early comprehensive geriatric assessment (CGA) in the acute hospital to prevent avoidable admissions to inpatient wards and remove barriers that can lead to longer stays for older patients. Important features of the service are senior clinical leadership and working with partners. The team works closely with care homes and residential homes, and refers patients to support services to minimise their risk of readmission. It also develops care plans to help primary and social care teams support patients. (Edited publisher abstract)
Moving healthcare closer to home: case study: Older People’s Assessment and Liaison (OPAL) Service: Gloucestershire Hospitals NHS Foundation Trust
- Author:
- MONITOR
- Publisher:
- Monitor
- Publication year:
- 2015
- Pagination:
- 4
- Place of publication:
- London
This is one of a suite of case studies designed to increase awareness of schemes to move healthcare closer to home. The Older People’s Assessment and Liaison (OPAL) Service at Gloucestershire Hospitals NHS Foundation Trust ensures that older people presenting at the trust’s A&E receive comprehensive clinical assessment and care planning from a consultant geriatrician. An important feature is the OPAL consultants’ close working with the integrated discharge team to facilitate supported discharge and recovery at home. (Edited publisher abstract)
Moving healthcare closer to home: literature review of clinical impacts
- Author:
- MONITOR
- Publisher:
- Monitor
- Publication year:
- 2015
- Pagination:
- 16
- Place of publication:
- London
A summary of evidence on possible quality and outcome impacts for patients of providing care in community-based settings rather than hospital, based on searches in PubMed, life science journals and online books. The literature reviewed finds clear benefits to returning patients home if they no longer need additional healthcare. It also finds there could be benefits to providing equivalent healthcare in community-based settings as alternatives to acute hospital care. Analysis of hospital bed audit data shows there is an opportunity to move substantial numbers of patients in acute hospitals either straight back home or to settings more appropriate to their needs. Patients can avoid harm and are generally happier receiving equivalent healthcare in community-based settings. The review suggests that from a clinical viewpoint, local health systems should first consider how best to avoid admissions and assist discharge from acute hospitals for patients who have less severe health needs and do not need acute hospital level healthcare. This paper is part of a suite of materials developed to support providers and commissioners making decisions about schemes to move healthcare currently provided in acute hospitals to community-based settings. (Edited publisher abstract)
Moving healthcare closer to home: financial impacts
- Author:
- MONITOR
- Publisher:
- Monitor
- Publication year:
- 2015
- Pagination:
- 40
- Place of publication:
- London
This paper is part of a suite of materials developed to support providers and commissioners who are making decisions about schemes to move care currently provided in acute hospitals to community-based settings. The paper presents key findings on the costs of delivering care through these schemes, compared to delivering care in an acute setting. To make the comparison, the study has modelled the potential effect on cost expenditure of four established types of scheme that deliver healthcare closer to home: telehealth schemes; enhanced step-up schemes; rapid response and early supported discharge schemes; and reablement services. The findings relate to a typical suburban local health economy over five years. The four types of scheme aim either to divert acutely unwell patients from being admitted into an acute hospital, to speed up their discharge or to reduce their ongoing care needs. Key findings include: in the long run, the costs of delivering care in the community may be lower than those of delivering care in acute hospitals; movements in cost and demand mean schemes are likely to be more important for avoiding future costs than for yielding immediate savings; these schemes are one important tool in the wider toolkit for addressing hospital financial and operational challenges; and the schemes will still need to be well designed to be cost-effective. (Edited publisher abstract)
Moving healthcare closer to home: implementation considerations
- Author:
- MONITOR
- Publisher:
- Monitor
- Publication year:
- 2015
- Pagination:
- 19
- Place of publication:
- London
This paper is part of a suite of materials developed to support providers and commissioners making decisions about schemes to move healthcare currently provided in acute hospitals to community-based settings. It describe the five most frequently mentioned implementation challenges and how providers and commissioners have tackled some of them to help the sector plan and implement community-based healthcare schemes. The five challenges are: ensuring the scheme targets the intended patients; meeting the needs of higher severity patients; recruiting, managing and motivating the right staff; building credibility and scale; and collecting data to evaluate effectiveness and setting payment incentives. (Edited publisher abstract)