Case study summary
An innovative approach to health and social care in Birmingham has helped to prevent more than 10,000 people being unnecessarily admitted to hospital in the last twelve months.
NHS Birmingham Integrated Care Partnership (BICP).
What was the aim?
Birmingham’s Early Intervention Lead and Birmingham Community Healthcare’s Chief Operating Officer Chris Holt outlined the aims: ‘Our Early Intervention approach is very different to what has been provided for the 1.3m+ people of Birmingham before and is the first of its kind for the city.
‘Our EI goals are to prevent unnecessary hospital admissions and premature admissions to long-term residential care, reduce delays in discharge from hospital and help people to remain as independent as possible in their own home.’
What was the solution?
The solution was a true partnership approach, with more than 1000 staff from six organisations across Birmingham joining forces to deliver EI. These were Birmingham City Council, Birmingham Community Healthcare NHS Foundation Trust, University Hospitals Birmingham, Birmingham & Solihull Mental Health Foundation Trust, Birmingham and Solihull CCG (now ICB).
The EI approach underwent an intensive four-month programme of testing across Birmingham following a review in 2017 by the Care Quality Commission (CQC) and the system partners which highlighted where improvements could be made.
Balwinder Kaur, Assistant Director, Acute, Community and Social Work Operations for Adult Social Care in Birmingham City Council added: ‘By working together the team can help to meet the needs of the person standing before us – whether that’s for depression, loneliness, a physical or mental health condition or a practical problem with housing, living or even losing weight.
‘It’s about having a huge bank of skills and knowledge which span the health, social care and voluntary sector and knowing where a person can get the right help at the right time to support them at home. So far, it’s been a real success and patients have been delighted to realise they aren’t going to have a long stay, someone is trying to help them get home as soon as it’s appropriate.’
Andrew McKirgan, Chief Officer, Out of Hospital Services for UHB added: ‘The health and independence of older people is a priority for Birmingham. At a time of intense pressure on our health and social care system it is playing an invaluable role in ensuring that hospital and care home beds are there for those most in need, and those that are medically fit to return home, can do so with the right level of support, or can avoid a trip to hospital in the first place.’
What were the challenges?
Previously the system was very fragmented with multiple organisations and multiple teams involved. People in elderly care and on longer stay wards could have been better looked after elsewhere, were often delayed leaving hospital and could have achieved a more suitable route out of hospital, better suited to their needs.
What were the results?
The new Early Intervention (EI) approach has also helped to reduce a people’s length of stay in hospital, saving 90,000 bed days a year and ensured that 45% of people are now more likely to go straight home when discharged from hospital instead of being admitted into long-term care.
Altogether the EI programme has created a financial benefit valued at £26.7m for the city’s health and social care system enabling more to done within the resources available.
EI services are delivered at the Queen Elizabeth Birmingham, Solihull, Good Hope and Heartlands hospitals and in community hospitals, social care services and mental health services across the city. In addition, there is a new community team which manages on average 300 referrals a week and a city-wide case load of 1000 a week. Its care approach means that people who are discharged from the service need on average six hours less care a week than pre-EI.
By easing pressure on the health and social care system, the services are also playing an integral role in the city’s response to the coronavirus pandemic. It includes a dedicated COVID-19 pathway which ensures that people recovering from the virus can benefit from intensive rehabilitation support in their own surroundings.
What were the learning points?
The system is now simpler. Bringing together colleagues from across health and social care from all the organisations to create single multi professional teams means that there is no wrong door for anybody who needs help – the aim being that people only have to tell their story once.
People will now see one team which works together and navigates the system for the person. All teams include doctors, nurses, physios, therapists and social care staff and all work in collaboration with the different EI services available.