Leicester is a city with high risk factors for emergency care; for people over 85 and frail people under 65. With a range of communities and cultures, there are elements of socio-economic deprivation and chronic illness, with low health literacy. This example of a local initiative forms part of our managing transfers of care resource.
A system review highlighted a lack of clinical confidence to not admit, and a range of services that were not coordinated or timely enough.
The crisis response service was established as a 24/7, 365 day solution for all client groups. Funded via the BCF, daily multi-disciplinary meetings take place in a co-located hub, which is operationally integrated with community health services, mental health services for older people and therapy services.
The model offers up to 72 hours of support, which includes care, assessment, risk management and wraparound services such as equipment, assistive technologies and handyperson.
In 2016/17 there were 6,343 client episodes. Of these:
- 100 per cent received a response within two hours
- 1,402 were related to falls – with 93 per cent remaining supported at home
- 50 per cent of cases received a joint intervention with community health services
- 1,413 supported exits from hospital – both preadmission and post-admission
- 80 per cent remain at home long term (55 per cent with no ongoing support).
As well as achieving exceptional patient satisfaction rates, the service has had a positive impact on attendances at A&E and delayed transfers of care.
Mark Pierce, Senior Strategy and Implementation Manager at Leicester City CCG, concludes: “The integrated crisis response service has been a critical partner for Leicester City CCG over the past three years in our drive to contain and then reduce the level of unscheduled admissions and attendances to hospital. I have no hesitation in saying that this service has been a game-changer for the local health and care system in helping us deliver more of the right care in the right place at the right time. It has been a model for other partners in understanding the power of ‘can-do’ and working together at pace.”
Contact
Jagjit Singh Bains
Head of Service Leicester City Council
[email protected]