We have an ambition for the NHS to strengthen its support for the people who live and work in and around care homes. People living in care homes should expect the same level of support as if they were living in their own home – but this can only be achieved through collaborative working between health, social care, voluntary, community, and social enterprise (VCSE) sector and care home partners.
The NHS Long Term Plan commits to rolling out the Enhanced Health in Care Homes (EHCH) model across England by 2024, starting in 2020. This model moves away from traditional reactive models of care delivery towards proactive care that is centred on the needs of individual residents, their families and care home staff. Such care can only be achieved through a whole-system, collaborative approach.
Requirements for the delivery of EHCHs by primary care networks (PCNs) are included in the 2020/21 Network Contact DES and associated guidance, with corresponding requirements for community health services and other NHS providers in the NHS Standard Contract. These requirements were fully implemented from 1 October 2020, with preparatory requirements completed by 31 July 2020, which include:
- every care home being aligned to a named PCN
- every care home having a named clinical lead
- a weekly ‘home round’ or ‘check in’ with residents prioritised for review based on MDT clinical judgement and care home advice (this is not intended to be a weekly review for all residents)
- within 7 days of re/admission to a care home, a resident will have a person-centred holistic health assessment of need (will include physical, psychological, functional, social and environmental needs of the person and can draw on existing assessments that have taken place outside of the home, as long as it reflects their goals)
- within 7 days of re/admission to a care home, a resident will have in place personalised care and support plan(s), based upon their holistic assessment
- the Network Contract DES also has a contractual requirement to prioritise care home residents who would benefit from a Structured Medication Review (SMR).
The Enhanced Health in Care Homes Framework has been updated to support the delivery of the minimum standards described in these contracts, and sets out practical guidance and best practice for CCGs, PCNs and other providers and stakeholders as they work collaboratively to develop a mature EHCH service, and should be read alongside these contractual requirements.
This programme is supported by our work to ensure that Urgent Community Response is accessible to people living in a care home, increased support for nurses working in care homes through a national network, and the appointment of a chief advisor on care home nursing. Information will also be shared more easily and securely between the NHS and care homes, with NHSmail, now available to all care homes. It also supports video conferencing, enabling a virtual home round if necessary.
The Care Provider Alliance has published a guide for care homes on the enhanced health in care homes (EHCH) service developed by our Community Services and Ageing Well team. The guide provides advice for care home managers on how to support their residents to benefit from the service. It also provides information on how to work effectively with their PCN clinical lead to ensure the health of their residents is improved.