Southern Health NHS Foundation Trust, in partnership with Hampshire Hospitals NHS Foundation Trust and South Central Ambulance Service (SCAS), and Wessex Academic Health Science Network, have been shortlisted for a National Health Service Journal (HSJ) Patient Safety Awards for 'improving care for older people initiative of the year' for their falls and frailty care service – designed to treat patients at home, who have fallen or are experiencing frailty symptoms, and avoid a trip to the Emergency Department.
This award nominated service was initially set up as a way of providing falls and frailty care to a large number of elderly patients who were at that time shielding from COVID-19 and going to hospital was too risky to their health. By taking the skilled staff to their home to deliver care ensured that they were still able to get the treatment they needed, without adding to the risk of contracting COVID-19.
Consisting of a specialist paramedic from South Central Ambulance Service and a frailty specialist clinician from Southern Health and Hampshire Hospitals, the team are dispatched in the “frailty car” which carries adaptive equipment to support and facilitate therapeutic interventions and assessments to treat patients in their own homes.
The team typically attends to patients who have had a fall or are displaying related symptoms associated with frailty. They can assess and treat underlying illness and minor wounds, assess mobility and function, and provide appropriate equipment to enable them to remain at home safely, with wrap around support provided where needed with the hospital at home.
This service has now seen over 1,000 patients within their homes since November 2020 of which around 79% have not needed to be admitted to hospital, have been treated in their own home and received follow up appointments from the urgent community response teams.
Naomi Purdie, consultant nurse in frailty at Southern Health NHS Foundation Trust says;
“The most important thing is patient safety and that means the quickest response and the most appropriate care. This service is delivering healthcare closer to home and improving healthcare for older people in an integrated way, through cross organisational working. The patients think it is part of the service from the ambulance – so don’t recognise it as anything other than a response from the ambulance service at first, which is great as it demonstrates it’s a seamless service.”
John Lloyd, team leader, specialist paramedic from South Central Ambulance Service added;
“The frailty car can be dispatched in a number of ways, via the 999 call centre, 111 call centre, referrals from GPs and we are averaging around five visits a day. Not only is this service ensuring that the patient receives the best care without the need to attend hospital, it is alleviating pressure on Emergency departments, providing safer care for those at higher risk of catching COVID-19, but who were also at risk of falling and becoming immobile”.
Hannah Munns, Frailty Matron at Basingstoke hospital, Hampshire Hospitals NHS Foundation Trust explains “The key to its success is excellent liaison between clinicians from community, emergency and acute services, so if a patient does need to be admitted it is as smooth and co-ordinated as possible. We are so proud of this service – working together to deliver high quality care in the right environment for our patient.”
Cheryl Davies, Senior Programme Manager at Wessex AHSN, said “In working with Southern Health, SCAS and HHFT to develop this innovative service for people living with frailty, we realised there was no standard approach to delivering an urgent community frailty response in other regions. We’ve developed an interactive toolkit built on real-life insight and best practice approaches to replicate this model across the country and support our health services to provide safe personalised care.”
The falls and frailty car service is part of Southern Health NHS Foundation Trust’s urgent community response team designed to deliver care in the home and follow up with the urgent community response team to monitor treatment and progress.
The winners of this award will be announced in mid September.