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How the care homes vanguards can bring together local health and care systems
The national new care models programme brings together local health and care systems as vanguards to radically redesign care for the local populations they serve. This week, William Roberts, National Lead for Enhanced Health in Care Homes, delivered an update on the vanguards at the Care and Dementia Show. He also presented a session at the Health Innovation Network’s ‘Sharing the Best Conference’. William reflected on the importance of integration and discussed the opportunities that are available when heath and care systems are better joined up and work together hand in hand.
The other week marked 21 years since I first started working in the NHS, and it coincided with the release by NHS England of the enhanced health in care homes framework, possibly the most exciting piece of work I’ve been involved in.
Six sites across the country – known as vanguards – are working across health and social care to test new ways of providing coordinated, high-quality care and support to care home residents.
We have captured the work they’re doing in the framework, it identifies a range of different elements that, when delivered together, make significant improvements in the quality of care and support provided to care home residents.
A couple of notable examples in the framework include: Connecting Care – Wakefield District vanguard, which has been using multidisciplinary teams across both health and social care.
The MDT uses a screening process to identify care needs which, if not met, may lead to residents needing to be admitted to hospital unnecessarily. The team can then raise issues with the care home, support them to meet the needs of residents and improve their quality of life – at the same time reducing unnecessary pressure on hospitals.
In Sutton Homes of Care vanguard, a ‘care co-ordinator’ role has been developed to bolster nursing leadership within care homes and to maximise the input they have into the way GPs review the care their residents receive.
Improving the care we offer to residents is important because there are nearly 400,000 people in England who live in long-term residential care and we face the challenge of supporting an ageing population and an increase in the level of acuity of people living with long term conditions in the community.
The work the care home vanguards have done builds on existing good practice and seeks to ensure that the services supporting care home residents are of a consistent and high quality standard.
There are many other great examples of the work the care home vanguards are doing. Whether it’s through nearly 220 care homes receiving telehealth support from Airedale & Partners vanguard or the eight professional groups working as part of the ‘pathway of care’ teams supporting care home residents in Gateshead Care Home Project.
Or it could be the care home residents in Wakefield vanguard receiving support from a range community groups or the on average two to four days that a resident is able to return to their home earlier if accompanied by the Sutton Homes of Care vanguard ‘red bag’. Or the on average seven medicines stopped for each resident after a medicines review in East and North Hertfordshire Clinical Commissioning Group vanguard or the care homes benefiting from an integrated contractual approach in Nottingham City Clinical Commissioning Group vanguard.
The care home vanguards show that through a focused and coordinated approach and by implementing a series of small “big ideas”, residents can experience significant benefits.
Having travelled the country over the last year covering nearly 60,000 miles, visiting many different places who have implemented elements of the framework already, we know that there is great care happening in many different parts of the country.
The challenge for next year and beyond will be to ensure that we spread the good work we’ve seen in the vanguards consistently across the country so that all care home residents benefit from high quality integrated care.
I hope that a year from now as I celebrate 22 years in the NHS I’ll be able to talk about every care home resident getting the kind of great care we’re seeing in the vanguards. To ensure this happens we will look to work with local areas in 2017/18 to help them identify where they have gaps against the framework and how they can best fill them to deliver high quality joined up care.
Later this year we will launch a self-assessment tool to help local areas understand the gaps and look to share the learning and great work from the vanguards and others who are now delivering high-quality enhanced health care to care home residents.
William, It was a pleasure to hear you speak at the Kings Fund EHCH conference earlier this week. I am the program manager for the regulated care transformation work-stream across Pennine-Lancs. We have been mapping our position in relation to the recommendations in the EHCH framework and building this into our new models of care specifications for consultation in the new year. I am struggling at the moment to articulate the outcomes in terms of impact on activity for the economic modelling process currently underway, specifically re: up skilling staff in care homes. can anyone assist me by directing me to evidence which will demonstrate outcomes. I have some local Newton’s data which illustrates some efficiencies relating to DNs which could be used as proxy data, but I wondered if there’s anything which will do the job better?
We’re doing some good work up here in Pennine-Lancs, but always looking at how we can learn from others and would value your input & advice.
Thank you for taking the time to post this comment. William has seen it and will be contacting you direct via email to discuss further.
This joined up thinking is absolutely spot on, I hope to be implementing the new care models as I am about to start working for a fairly new and dynamic Nursing home group in the North West; Athena Health Care, as their Clinical Teacher. ( Previously I was S/L Nursing University of Cumbria). Athena Health Care have already incorporated District Nurse rooms in there homes, and they have brilliant initiatives to link with the local community, their ethos is be fully integrated.
Well done for leading this ! Fiona Cassells
My recent experience of my elderly father in law being placed into Residential Care left us all traumatized he is being removed, and a live in Carer specializing in Dementia has been decided. It is in fact more expensive, but with the family around them, and the younger members of the family keen to interact with him it has to be better, than walking the corridors of ‘death’ dramatic but true.
I negotiated with another Care Home (excellent) for him to take part in their activities. I took him from one Care Home i was paying, to another one, he was a different person.
There are many ‘initiatives’ that could be implemented that could save the NHS /LA money, but the Statutory Agencies are set in it’s thinking.
I will repeat this you have to ‘live the dream’ to know it can and should be done better.