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Partnership helps reduce elderly hospital admissions

Wednesday, 09 July, 2014
Partnership helps reduce elderly hospital admissions

More public sector partnerships are helping North Tyneside’s older residents to reduce the need for hospital treatment and improve their health and well-being.

Housing officers, who work in the frontline with tenants of North Tyneside’s sheltered housing schemes, have been trained to make direct referrals on their behalf to emergency care nurse practitioners who work as part of a dedicated ‘Admission Avoidance Resource Team’ (AART) in North Tyneside.

Any tenant with a minor injury or illness can get their sheltered housing officer to call Northumbria Healthcare NHS Foundation Trust’s emergency care nurse practitioners who will respond within two hours.

In addition, these NHS services can provide over the phone advice to the sheltered housing officers on behalf of tenants.

The new way of working is the result of a Knowledge Transfer Partnership, involving North Tyneside Council’s Quality Homes for Older People project and Northumbria University. This involves academics from Northumbria University working with the council’s housing service, North Tyneside Homes, to develop new ways of working, together with Northumbria Healthcare NHS Foundation Trust.

Councillor John Harrison, Cabinet member for Housing and Environment said: “We want to ensure that our tenants can enjoy independent living in our new sheltered housing accommodation for as long as possible. Promoting better health and wellbeing will enable our tenants to do so.

“Our sheltered housing officers, who are valued key points of contact for our tenants, will play a key role in achieving that.

“The Knowledge Transfer Partnership has brought together the expertise of our housing officers, the academics at Northumbria University and our NHS colleagues to develop a more joined up way of working that helps improve the health of our tenants and reduces the burden on local health services by preventing unnecessary hospital admissions and reducing the lengths of stays in hospital.”

The emergency care nurse practitioners at Northumbria Healthcare are dedicated community-based specialists who proactively work with vulnerable elderly people to organise the right health care and support so that people can live independently at home and avoid being unnecessarily admitted to hospital.

The highly trained nurses can treat minor injuries and illnesses including assessing a patient after a fall, minor burns or scalds, sprains and strains, treating chest and urine infections and dressing grazes. They provide treatment at the patient’s home and aim to respond within two hours of a call. They can provide prescriptions, carry out some tests and work with elderly patients to help prevent emergency admissions to hospital and reduce the length of any stay in hospital.

Northumbria Healthcare’s emergency nurse practitioners are part of the multidisciplinary AART team in North Tyneside which provides rehabilitation in patients’ own homes and can organise any necessary specialist equipment or adaptations to peoples’ homes to support independent living.

Julie Slorance, district and community nursing service manager from Northumbria Healthcare NHS Foundation Trust said: It’s great news that for the first time we are able to support North Tyneside Council’s housing officers in this way and play a role in helping residents to remain in the community for as long as possible.

“No one really wants to come into hospital if they can avoid it and it’s really important that elderly people stay in familiar surroundings, with the right support, if they are able to.”

Sheltered housing officers can also directly refer tenants to the Council’s Adult Social Care Reablement team, which can work intensively with patients for up to six weeks. They aim to restore the patient’s confidence and independence by working with the individual to understand their worries, needs and concerns and then make sure they put all the appropriate support in place to deal with these.

Glenda Cook, Professor of Nursing at Northumbria University, said: “Central to the effectiveness of the new North Tyneside Homes service model is the provision of early intervention in the case of injury and illness, preventative and enabling services.

“Integrated working between the local authority and Northumbria Healthcare NHS Foundation Trust will ensure that older and disabled tenants will be treated promptly in their own home – reducing the need for ambulance journeys and unplanned admissions to hospital.

“Feedback from service users and their families who have been involved in the pilot service development was extremely positive.

“The approach taken in North Tyneside optimises the potential contribution of sheltered housing to the new delivery model of primary care services within the NHS Health & Social Care Act 2012 and the new statutory duties of Councils to meet health and well-being needs of local populations.”

Joan Brewis, 84 from Whitley Bay is one patient who has recently benefitted from the joined up working between the NHS and the council.  Joan has glaucoma in both eyes and lives alone. Over the last 12 months she has fallen several times and in July when she fell at home she became bedridden with severe back pain. Mrs Brewis was no longer able to look after herself and moved in with her son who was providing 24 hour care. He alerted his GP and she was referred by a community nurse to the AART who assessed her and put a care package in place the same day as the referral. This included a rehabilitation bed at Coble House for intense rehab where she received nursing physiotherapy and occupational therapy assessments. She then returned home after 12 days with ongoing physio and occupational therapy and home care from North Tyneside Council’s Reablement Team for meal preparation, washing and dressing.

Mrs Brewis said: “I don’t think you can get any better than this. After I fell I needed a lot of help. I didn’t think I’d ever walk again. It was hopeless but they looked after me really well in hospital and they helped me to get home as quickly as possible.

“Then they were there for me at home straight away helping me to get back to my normal routine. I’ve been doing my exercises regularly and gradually getting my confidence back, and I think now I can make my own tea and go to bed without help. You could not get a better service and I feel better now than I did before my fall.”