Case study summary
A £2.5 million saving has been achieved in Camden as local services have joined forces to form a Rapid Response Team. Made up of senior nurses, occupational therapists, physiotherapists, a therapy practitioner and pharmacy provision, the team work to prevent unnecessary hospital admissions while enabling vulnerable residents to receive care closer to home.
The Rapid Response Team is another example of integrated care in action with NHS and social care staff working in a joined-up way to make a real difference to those most at need.
They do this by taking the lead from GPs, healthcare professionals and paramedics who after assessing a patient explore whether further treatment can be provided at home rather than hospital. Successful referral to the Rapid Response Team then sees them on scene within 2 hours.
One such referral was Mr Patel. Paramedics arrived to assess Mr Patel, aged 89, following a 999 call from his wife explaining he had been unwell for several days. Deciding he might better benefit from treatment at home rather than hospital paramedics referred Mr Patel to the Rapid Response Team. An occupational therapist arrived within thirty-five minutes organising ongoing support in the shape of afternoon and evening care, with a nurse arriving soon after to assess any underlying issues. With the right support in place Mr Patel was now already in a better position to start rehabilitation and get moving around his own home.
The implementation of this specialist team has seen GPs, paramedics and other healthcare professionals feeling they can confidently get in touch with the team to see if their patient can be treated well in the community rather than hospital. It has resulted in a 44% increase in year on year referrals to the service.
Patrick Hunter, senior clinical lead at the London Ambulance Service agrees, saying: “Training alongside the team has given our crews the confidence and professional trust to make this referral. Our referral rates have grown exponentially since we started this programme of joint training.”
And Dr Lyann Gross, a GP from North London who works closely with the team, says: “I always feel reassured to know I can speak to a senior nurse at the end of the phone and work with my Allied Health Professional colleagues to provide the best care possible for our patients.
“I have become amazed at the complexity of medical problems that the team can work with to help support the patient remaining in their own home.”
There are many reasons to keep people with frailty closer to home and out of hospital as Thomas Dowle, who leads the team as part of Camden Rapid Access Services, explains: “Older patients are at an increased risk of hospital acquired infections and falls due to an unfamiliar environment. These risks could result in the patient being unable to function as before the admission, resulting in them not returning home.
“Many admissions to hospital such as chest infections, urinary tract infections or mobility decline, are easily preventable. These conditions do, however, require prompt assessment and intervention, with this being achieved by community services such as a Rapid Response Team.”
Since 2013, the team has evolved to make huge savings, reduce hospital admissions and treat vulnerable people, such as the elderly, in their home. This patient group is most likely to be admitted to hospital due to a greater number of long-term conditions, alongside cognitive and functional decline.
The support the team can give primary care and the ambulance service has positive implications for the NHS and its patients. Patients treated out of a hospital setting frees up capacity for urgent care services to provide emergency treatment to those that need it. And patients treated at home, such as Mr Patel, can look forward to a complete and personalised care package.
It’s this integrated way of working that is at the heart of the NHS Long Term Plan, where health service providers are being supported to provide such care closer to home. The benefits of this being better care for patients, a visible reduction in cost and a reduction in unnecessary admissions. And Camden’s local care strategy is doing exactly that – providing a system wide approach to admission avoidance.
This smarter way of working is part of North London Partners in Health and Care’s quest to improve health and care for their residents. It also forms part of their journey to becoming an integrated care system to ensure the NHS can help people to live healthier lives for longer, and to stay out of hospital when they do not need to be there.