21 September 2016 - New model of care ‘better for patients’ say doctors

New model of care ‘better for patients’ say doctors

21 September 2016

A COMPREHENSIVE model of care for people who are frail or elderly is set to be discussed by health commissioners next week.

The model responds to the views of patients and clinical staff about what they wish to see provided in future.

More than 80 clinicians have worked on the model, which could see a much more responsive service in people’s homes – where it is safe and appropriate to do so.

There are sound clinical reasons for adopting the model.

GP Dr David Jenner, chairman of the Eastern locality for the Clinical Commissioning Group, said the care provided by NHS staff in our area was among the best in the country but there were also challenges.

“One of the biggest challenges for us is when out-dated models and a lack of coordination between services means we are not able to provide better care,” he said.

“We know we can do more to support a faster return home and also prevent unnecessary hospital admissions.

“Bed-based care will always be available for people who need to be in a hospital but we need to make sure the alternative of home-based care is always considered.

“Too many people are currently in hospitals that don’t need to be there and they could be receiving a better service at home.”

The proposed new model for East Devon includes:
  1. Comprehensive assessment to identify people who are frail or could soon be, to put a care plan in place to outline potential avenues for escalating care when it is required.
  2. A single point of access making it easier for GPs and others to get additional support when it is needed urgently.  It will be connected to a Comprehensive Rapid Response service.
  3. Comprehensive Rapid response (care at home) service, to help to people to remain at home with support, rather than being admitted to hospital and where hospital admission is unavoidable, it will provide the additional support at home that makes it safe to leave hospital.  This will include health and care workers delivering rehabilitation alongside traditional care.

The Governing Body of the Northern Eastern and Western Devon Clinical Commissioning Group (NEW Devon CCG) will meet on 28th September to consider giving the go-ahead to the consultation – giving people the opportunity have their say.

Up to 100 people are in community hospitals that should not be there; 600 people if acute hospitals are included – and that this increases the likelihood of harm.

Doctors add that a length of stay in hospital over 10 days can cause people’s health to deteriorate, particularly in relation to muscle strength, the risks of loss of mobility leading to increased falls, loss of confidence and independence - and advancing frailty.

“This is powerful motivation for us to improve the care we commission,” said Dr Jenner.

The proposed model builds on previous discussion during 2014/15 over the Transforming Community Services programme in which people said they wanted joined up care, which supported and promoted independence, as locally as possible.

If approved, the public consultation on proposals would begin October 7, 2016 and end January 6, 2017

Angela Pedder, former chief executive (CEO) of the Royal Devon and Exeter NHS Foundation trust and now lead CEO for programme, said difficult decisions lay ahead.

 “At times when people are at their most vulnerable and most in need of support, our current system requires them to navigate their way through the multiple boundaries that exist between services.
 
“Our GPs and other clinical staff also described similar difficulties. This results in delays, multiple assessments, and frequently the only care intervention available is an emergency referral to a hospital due to the lack of a more appropriate, easily accessible alternative service.

“We recognise the changes we are proposing will prompt difficult debate but we firmly believe the options in the consultation represent a real opportunity for us to improve care.”

The NHS in Northern, Eastern and Western has to achieve clinical and financial stability by 2021. These proposals are key to ensuring the improvement of care and financial health.

The Governing Body papers can be found here.

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