The goal of the East Birmingham Hub is to prevent ill-health, shift care from hospitals to the community and harness the latest technology to improve care. Its team focuses on improving care for people with high intensity use of emergency departments by offering personalised support at the neighbourhood level.

The hub is part of the wider Birmingham and Solihull Integrated Care System Community Care Collaborative (CCC) programme of work that is being led by Birmingham Community Healthcare Foundation Trust. The CCC partnership is made up of primary care, community, physical and mental health services, social care, acute care and voluntary, community, faith and social enterprise partners. 6 locality hubs are planned across Birmingham and Solihull.

The East Birmingham Hub is home to a host of multidisciplinary health and care services, which include the Care Coordination Centre, East Integrated Neighbourhood team, district nurses and intermediate care services, such as the urgent community response and the Early Intervention Community team. It also benefits from a co-located urgent treatment centre and community diagnostic centre.

Collectively these are helping to manage urgent care demand by liaising with GPs, care homes and Heartlands Hospital, the local acute hospital. They also co-ordinate patient community care pathways to help support hospital discharge or avoid hospital admission by seeing if the treatment they need can be provided in the community. This includes offering same day urgent care appointments to patients who need them to prevent the need for admission or multiple professional contacts. The teams also coordinate services, including social prescribing, community care and other key interventions, such as healthy lifestyle support, befriending and family and carer support.

The most recent addition to urgent care services at Washwood Heath is the launch of the respiratory same day emergency care service. This is providing people aged 18 and over with quick and easy access to specialist respiratory care in the community and is helping to avoid unnecessary hospital admissions.                                              

It is specifically for those with an exacerbation of chronic respiratory conditions, including chronic obstructive pulmonary disease (COPD), asthma, pneumonia, respiratory failure, bronchiectasis and interstitial lung disease. People are referred to the service by GPs, NHS 111, the single point of access and West Midlands ambulance service.

A specialist team – including a hospital consultant, GP and clinical nurse specialist – triage the referrals and book people in. Under the care of the respiratory team, people will also have access to radiology and urgent blood tests. They will then either be discharged, followed up with a GP, admitted to hospital at home (virtual ward) or referred to a community respiratory service.

Key learnings

• The voice of the GP has been important in shaping the policy and approach to address issues within and outside of primary care. This has been facilitated by a leadership presence on the GP partnership board. Additionally, there are GP representatives at weekly system chief executive officer meetings.
• Co-ordinating services (social care, community health services and mental health) in a more streamlined way and, wherever possible, co-locating them as close to people’s homes as possible supports integrated working and improves productivity. It creates the space for clinicians to spend more time with their patients and improve prevention, early detection, and management of long-term conditions such as COPD and diabetes, supporting complex patients to stay as independent as possible in their own homes.
• Close working with acute partners, including increasing the availability of urgent care services in the community – an urgent community response team, hospital at home (virtual wards), the early intervention community team and remote monitoring equipment in care homes – enables the hub to improve discharge and avoid admissions.
• Operational data is fed through to a local co-ordination centre. This includes live data on dischargeable patients, live care home remote monitoring data, alerts on ‘patients of interest’, emergency department attendances and community services activity and capacity.
• Dedicated support is provided to GPs via a GP provider support unit. The unit supports all practices across the integrated care board to improve sustainability, standardisation and improvement.

Impact

A recent evaluation conducted by the East Birmingham Hub reports that from December 2023 to December 2024, the work of its MDTs resulted in:

• 47% reduction in the number of GP appointments
• 5% reduction in emergency department attendances
• 22% reduction in inpatient spells
• 1.8 day reduction in length of stay where there has been an acute inpatient spell
• 41% reduction in number of outpatient appointments
• 49% reduction in the number of physical health community services contacts and appointments
• 148% increase in the number of mental health services contacts and appointments

Publication reference: PRN01756_ii