What was the issue you were addressing or working on?
This service was developed in response to the fact that older people can often be unnecessarily admitted to hospital, due to there being a lack of readily available transport to take them home, and the risk that the 4hr A&E target may be breached for them. It was recognised that patients may also be more likely to be admitted especially if they have arrived at A&E later in the day, and there is a lack of family/care support to ensure a safe return home.
In addition to this, a service that would support individuals into their own home, ensuring their safety and comfort, was seen to be beneficial both in terms of direct support to the patient, and potentially picking up on issues which might prevent further deterioration or a potential readmission to hospital.
What you did?
Initial discussions took place with British Red Cross regarding the possibility of developing this service. A steering group was set up involving the CHP, Acute, Social Work and BRC. From there a proposal was put to the RCOP Programme Board for Change Fund money to support a 3 month pilot. The proposal involved the recruitment of drivers to drive existing BRC vehicles and the recruitment of volunteers to do the follow up support. This was approved and, based on the success of the pilot, funding for a further year was granted.
The pilot commenced in January 2013 and more recently other local authority areas have joined (East Renfrewshire, East & West Dunbartonshire and the Camglen corridor of South Lanarkshire). Currently, we are working on a tender process with a view to delivering this service beyond the end of the Change Fund. The existing service costs approximately £130k per annum. Based on an ongoing analysis of the patient demography we will look to this service, in the long-term, being potentially funded from a combination of NHSGGC CHPs and Acute.
What were the outcomes - benefits or otherwise?
As at October 2013, 369 patients have been transported home and settled. Approximately 60% of these have been considered by A&E staff to be avoidable admissions, i.e. if this service was not available, it is likely the person would be admitted to hospital. So far, most patients are being collected from A&E within 45mins of the request for service being made. Patient feedback has also been extremely positive, particularly around the swiftness and person-centred approach of the service.
Contacts - to find out more
Rhoda Macleod, Rhoda.firstname.lastname@example.org 0141-276-6723
Christopher Campbell, Service Manager, British Red Cross, 4 Nasmyth Place, Glasgow, G52 4PR, 0141 891 4000 Christophercampbell@redcross.org.uk
Debbie Ambridge, Clinical Services Manager, Acute Services, Southern General Hospital, 1345 Govan Road, Glasgow, G51 4TF, 0141 201 1863 Debbie.Ambridge@ggc.scot.nhs.uk