What was the issue you were addressing or working on?
In 2009/10 there were 6,243 unplanned admissions to hospital of over 65s in Perth and Kinross. In the same year £35 million, over one third of the total Health and Social Care spend on people over 65 yrs, went to providing hospital based care.
Change Fund money has been used to implement a number of projects to try and reduce the number of unplanned admissions to hospital by providing community based alternatives. One of these alternatives is the Rapid Response Service.
What you did?
Perth & Kinross developed a rapid response service which commenced January 2012. The aim of the Rapid Response Service is to provide community based alternatives to unplanned admissions to hospital and crisis admissions to Care Homes for people in Perth and Kinross over 65 years old. This will shift the balance of care by reducing the number of unplanned admissions to hospital and Care Homes. The Service has 3 elements:
- Single Point of Contact (SPOC) created to access multi disciplinary support at time of crisis by employing SPOC clerical worker with a district nurse aligned to the access team, to provide nursing support with crisis situations in the Perth area, and liaise with and arrange other health supports as required.
- Eight Rapid Response Social Care Officers (RRSCOs) based within the Community Alarm Team available 24/7. 3 healthcare assistants were also recruited and part of their role was to assist with rapid response situations either directly or by freeing up district nursing capacity.
- Step Up beds in Care Homes throughout Perth and Kinross which are spot purchased from Care Homes as required.
What were the outcomes - benefits or otherwise?
A one year review of the service was completed and approval to continue the service was received from the Change Fund Executive Board. During the period May 2012 to June 2013 there were over 380 referrals into the service for support at home in an emergency. Of these only 65 were finally admitted to hospital and 13 being admitted to a care home. The majority of those who were admitted to hospital or care home were supported in their own homes for longer than they would have been without the service.
In addition to the annual review a rapid improvement event was held with key stakeholders to review the processes and to agree an integrated way forward. The improvements identified are being developed into an action plan.