Expert rapid response teams will be on hand within two hours to help support older people to remain well at home and avoid hospital admissions in the Norfolk and Waveney area, under new plans outlined by the NHS today.

Local health service and council teams will begin the roll out of Urgent Community Response teams from April, as part of the NHS’ Long Term Plan to support England’s ageing population and those with complex needs.

The teams will give those who need it fast access to a range of qualified professionals who can address both their health and social care needs, including physiotherapy and occupational therapy, medication prescribing and reviews, and help with staying well-fed and -hydrated.

Backed by £14m of investment, seven ‘accelerator’ sites, including Norfolk and Waveney, will be the first to deliver the new standards for care, working together to standardise how urgent community services will be measured, and delivered consistently across the country, 365 days a year.

Older people and adults with complex health needs who have a very urgent care need, including a risk of being hospitalised, will be able to access a response from a team of skilled professionals within two hours, to provide the care they need to remain independent.

A two day standard will also apply for teams to put in place tailored packages of intermediate care, or reablement services, for individuals in their own homes, with the aim of restoring independence and confidence after a hospital stay.

The urgent response standards are part of a range of commitments – including enhanced NHS support to care homes – which local health and care leaders will be rolling out over the next few years to help keep older people well at home and reduce pressure on hospital services.

NHS chief executive, Sir Simon Stevens, said: “The NHS working hand in glove in the community with council-funded social care services can be the difference between an older person or someone with long-term health needs spending a week or a month on a ward – or getting the right help early so they don’t need to go to hospital in the first place.

“That’s why as part of our Long Term Plan for the NHS we are putting community services front and centre, and backing them with a growing share of the NHS budget – and putting in place these new standards will give people and their families peace of mind about what they can expect from their local services when they need help most.”

NHS teams in seven parts of the country will begin working with their local authority counterparts on developing the services and recruiting staff from April, with the ambition that at least three areas will be fully up and running by next winter.

Further areas across England will receive extra funding to begin working to the new standards from 2021, with every part of the country covered by April 2023.

This will be supported by an additional £4.5billion a year for primary care and community services by 2023/24.

Secretary of State for Health and Social Care, Matt Hancock, said: “Long, avoidable hospital stays can be particularly distressing for older people and can strip them of their independence – something we absolutely must prevent.

“So we are rolling out this innovative new approach which will help treat our ageing population in the comfort of their own homes, helping them live independent lives for longer. This is a key part of the NHS Long Term Plan, backed by record investment in the NHS, and we are committed to making sure this translates to better, safer care in the community.”

Shifting more care out of hospital and into the community is the first of five major improvements in how the changing health needs of the country will be met over the coming decade to be set out in the NHS Long Term Plan last year.

Josie Spencer, CEO of Norfolk Community Health and Care NHS Trust and Norfolk and Chair of Norfolk and Waveney Ageing Well Steering Group, said: “Norfolk and Waveney Health and Care Partnership is delighted to have been selected as one of the seven accelerator sites to support the delivery of the new national standard for urgent community response.

“Norfolk and Waveney is predominantly rural and spread over a large geographical footprint. Providing effective integrated care and support to our population of over 900,000 people is a challenge that we are already working as an integrated health and care system to address.

“Being an Ageing Well accelerator site means we will receive investment to help us make additional changes that really change the way we work by providing coordinated assessments of people in need of urgent support. This will ensure people receive suitable care in the quickest possible time, in the most appropriate place.

“Our Network Escalation Avoidance Teams (NEAT) will play a key role in the Ageing Well Urgent Community Response (UCR) Pathway.  NEATs are teams of health and care staff from different organisations working together; they take calls from frontline doctors, nurses, social care staff or other professionals when a patient is facing a crisis and would otherwise need to go to hospital. The team quickly put together a co-ordinated package of care and look at how the person can be supported in the future to avoid a similar crisis.

“We’re particularly looking at how we can increase the number of people who benefit from the type of multi-disciplinary team assessments they conduct.”

Reablement services aim to help people, particularly older people, remain independent by:

• providing support and rehabilitation to people at risk of admission to, or who have been in, hospital;
• helping make their transfer out of hospital as smooth as possible;
• ensuring people can remain in their own home for as long as possible, and;
• offering short-term support to people living at home who find daily activities difficult.

Studies show the services – provided by teams made up of a range of professionals such as nurses, physiotherapists, occupational therapists, social workers and social care staff – are highly effective in helping people regain or maintain their independence.

As well as being better for the individuals involved, it’s more cost-effective for the NHS than providing care in hospital, and also means beds can be made available more quickly for patients who need them.

Health and social care systems across the country already work hard to support people at home, putting in place personalised packages of care including physiotherapy, nursing care, and occupational therapy.

However, up to now the NHS hasn’t set national expectations or strategy, meaning that there is wide variation in how these services are delivered across the country.

At present, no part of the country is consistently delivering community urgent care services 365 days a year in line with these new national standards – meaning that all areas are expected to see a significant improvement in the offer to local people.

Seven ‘accelerator’ sites have been selected to develop the two hour/two day NHS standards, and include partnerships of providers of community health services, NHS commissioners, councils and adult social care teams, and 111 and ambulance services.

They are:

• Warrington Together (Cheshire and Merseyside STP);
• West Yorkshire and Harrogate Health and Care Partnership (Kirklees);
• Leicester, Leicestershire and Rutland system;
• Cornwall system;
• Buckinghamshire, Oxfordshire and Berkshire system;
• South East London system; and
• Norfolk and Waveney Health and Care Partnership.