seven day services: a local authority perspective
Post on 22-May-2015
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Ruth Lake Director of Adult Social Care and Safeguarding
Leicester City Council
To share a view
To explore 2 initiatives
To consider future opportunities though the integration agenda
Closely linked to the sub-region though NHS provider trust arrangements
A challenged health and social care economy
Long history of joint work on acute care agenda – focus on ‘flow’
Low social care delays from acute settings
Lots and lots of actions; no sustained improvements
Integrated Crisis Response Service (ICRS)
Social care and health services providing 24/7 rapid response to crisis
2 hours response time
Cases held up to 72 hrs
Hand over if ongoing need
Virtual integration social care provider staff, community health services including OPMH, AT, handypersons, community alarms
Focus on community cases, A&E diversion
Provider –led initiative Developed in response to operational
challenges Addresses service gap noted by users / carers
and professionals 10pm to 7am gap; weekend ‘assessment
capacity’ gap Coordinated provider-led bids for funding Use of reablement monies initially Future funding via BCF / health transfers to
LA
Operational since November 2012
2 813 referrals – majority seen within 1 hour
Main referrals source community alarms (80%) with others spread across acute, community health, primary care, EDT
Top 3 issues: ◦ Falls
◦ Personal care
◦ Inability to transfer
470 packages provided during the72 hour period
26% requiring no further services
36% referred into reablement
24% requiring maintenance package (at same or higher level)
Routine follow up by DN
Medication review
Falls assessment
Community equipment
OPMH involvement
Very high levels of satisfaction
Falls – evident reduction in ambulance call outs and reduced conveyances
Resultant comprehensive assessment has preventative benefit - independence
Ability to respond to 7 day services agenda
Route for hospital diversion that didn’t previously exist
Reduced duplication and improved flow
Systems savings
‘Super weekends’
Proof of concept event
Whole system step up to business as usual on Saturday and Sunday
2 weekends in January 2014
Sponsored by the Urgent Care Board to test a theory on reducing acute pressures
Well-established additional working days to support peak / holiday periods
Existing provider led response (ICRS / Reablement) for simple discharges
Social worker assessment capacity usually limited
Input of small care management team on super weekend dates
Full duties – new referrals, action on existing discharge notifications
The whole system did step up
Busy 1st weekend with work that could be progressed
Focus on known discharge cases rather than newly referred
Flushed out gaps – pharmacy, equipment, independent sector preparedness, knowing what is available
If one part is missing, overall impact is lost
Maintaining Saturday working
ICRS a keystone in Better Care Fund plans
Links to new primary care Clinical Response Service
Good early outcomes
BCF to build ICRS and assessment capacity to support acute to community shift and 7 day services
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