Home Care Re-ablement

Examples of Practice

Users of the previous traditional home care service received a service that operated in a culture of ‘doing things for’ people that reinforced deficits and increased dependency. This ‘locked in’ resources with people who had the potential to improve their confidence, self esteem and independence while demand for the service was increasing because of the growing numbers of older people. In addition, there were financial pressures on the local authority.

Read more

Befriending Plus

Examples of Practice

Older people are increasingly experiencing social isolation. Statutory services are unable to provide the one-to-one social aspect that a volunteer can provide which is a proven intervention in improving people’s mental health and wellbeing, reducing social isolation and providing associated health benefits of people re-engaging with their community through support.

Contact with a volunteer on a regular basis provides the opportunity for observation of a befriendee’s wellbeing and allows interventions to be explored or offered before the situation deteriorates to crisis level.

We believe that Befriending Plus complements the changing emphasis of statutory service provision towards re-ablement and helps to reduce the high demand on health and social care services.

Read more

Long Term Respite requirements

Examples of Practice

Support for carers where the continual disturbance of sleep is placing an intolerable pressure on family carers, placing the carers health at risk and affects their capacity to continue with caring tasks safely and adequately, and may result in the breakdown of care at home arrangements.

Read more

Modernising Community Nursing

Examples of Practice

The Western Isles has a changing demographic with a higher population of older people than the Scottish average, this coupled with an ageing workforce and outward migration of young people has brought into focus the need  to continue with the modernisation of our acute services and deliver more services closer to communities.

In conducting a review of unscheduled care the National Dashboard summarises NHS Western Isles performance as:

  • A&E attendances -7% WI v.+ 1%  Scotland
  • A&E admissions : -6% WI v. +10% Scotland
  • A&E admissions as % of non-routine discharges: 65% WI v. 71% Scotland
  • Ave. Stay Emergency stay (WIH ) : 5 days less than Q4 2011
  • Acute beds: down 12% WI v. 2% Scotland
  • Acute Beds per 1,000 acute discharges: 66 WI v. 44 Scotland
  • Acute emergency discharges: -2.5% WI v. +2% Scotland
  • Acute non-emergency discharges: -2.5% WI v. +2.6% Scotland
  • Beds lost to DDs: 7 WI

In summary for latest period WI has reducing lengths of stay reflecting reduced bed numbers and reduced acute admissions (both emergency and elective) in turn reflecting reduced A&E attendances and onward admissions from A&E.  Some of this contrary to Scottish trend (See above list) but remain above average in comparison to Scottish levels for few areas eg. ALoS and Number of beds relative to number of patients. 

NHS Western Isles approach is integrating all of our Unscheduled Care activity under a single work stream, taking a whole system approach and working closely with service users, Local Authority partners and Third Sector providers. This work is ongoing.

Read more