Intermediate Care Staff Newsletter

RDASH Awards NightSuccess for Rapid Response Team!

Number 7

Welcome to the seventh edition of CONNECTED, the staff newsletter for Intermediate Care Services in Doncaster. The aim is to keep staff informed of developments in the intermediate health and social care project and to provide an opportunity to share good news and best practice across all teams.

The project team will be co-ordinating the production of the newsletter so please contact Paul Burton, details below, if you have some news you would like to include.

paul.burton@nhs.net direct line 01302 566020

For more information about the project follow this link to the Intermediate Care webpage on the Doncaster CCG website

http://www.doncasterccg.nhs.uk/your-care/intermediate-care

In November the Rotherham, Doncaster and South Humber NHS Foundation Trust hosted its yearly award ceremony to celebrate a service that is built on the skills, talent and commitment of staff. Each year they recognise and celebrate the achievements of their staff in operational and support services.

There were over 200 entries received for the 9 categories which had to be shortlisted down to 5 entries for each category. The Rapid Response Team which is made up of professionals from various health and social care organisations, was nominated and successfully shortlisted for three categories;

• Clinical Team of the Year

• Partnership Working Award

• Service Transformation Award

All three nominations received runner-up certificates, great recognition of the hard work put into the pathway by all involved and the fantastic outcomes now beginning to be seen.

For more information and photos follow these links:

http://nww.intranet.rdash.nhs.uk/80179/celebrating-success-at-our-awards/

http://www.rdash.nhs.uk/wp-content/uploads/2017/11/Trust-Matters-November-2017.pdf

Number 7

The iDCR is a new electronic system for sharing patient information, it pulls together patient health and social care details from 6 systems (5 clinical and 1 social care) from 5 organisations. This information will be viewed via a secure NHS based portal. The diagram below shows what information will be available in the iDCR when it goes live. Access to view the iDCR will be role based, so that workers only see what is appropriate for their role.

Being able to see patient records at any time, in different locations, means that health and social care professionals can make quicker and safer decisions about a patient’s care. Initially, the iDCR will only be available to teams and professionals involved in providing the Rapid Response Pathway to prevent unnecessary hospital admissions and facilitate discharge.

The technical teams at each organisation have been working hard to ensure key information recorded on the six source systems is transferred to the iDCR.

System testing and training sessions are also planned over the coming weeks. Partner colleagues say they can’t wait to start using the iDCR as they will have access to so much more information than they currently do!

For more information please take a look at the website

http://www.doncasterccg.nhs.uk/idcr/

The website is still work in progress, and currently contains the most important information.

We plan to add more content as we get closer to the Go Live and will be including staff and patient videos and additional FAQs.

If you have any immediate queries about the iDCR system please contact:

Wendy Lawrence, IT Programme and Service Delivery Manager, Doncaster CCG:

Email: wlawrence@nhs.net

Tel: 01302 566039 or 01709 302198

Update on the Integrated Digital Care Record (iDCR) Project

Partner colleagues that have been involved in the design of the iDCR say they can’t wait to start using it as they will have access to so much more information than they currently do.

Number 7

A mixture of 29 staff from The Yorkshire Ambulance Service (YAS) and Doncaster Rapid Response team/ SPA attended a CPD session on Wednesday 10th January hosted by YAS at Doncaster ambulance station.

YAS and Rapid Response Teams building relations

iDCR Public Communications

The theme of the night was right care, right place with the aim to promote a better understanding of each other’s services, build lasting healthy professional relationships, to ultimately improve patient care by ensuring that patients are treated at home wherever possible.

Building on an already healthy relationship between the services, staff were able, through a workshop style event, to ask questions to improve on the referral pathway for the future.

Key themes to come out of the event were; how YAS staff have new understanding of the service and value the pathway in providing the best care for their patients. The rapid team understand some of the challenges faced by ambulance clinicians when deciding on suitable treatment and referral options.

A poster highlighting the outputs from the CPD event has been produced and is available on this link:

http://www.doncasterccg.nhs.uk/wp-content/uploads/2018/01/CPD-event-outcomes-poster.pdf

We have also launched our communications plan with the public, staff and external stakeholders. Members of the public can choose to opt-out of sharing information to the iDCR. The opt-out process is detailed on the website. An information leaflet has also been created. This was reviewed by Healthwatch, the Doncaster Wide Comms Group and the Listen to Learn Network, and is now available to download. Printed copies have also been distributed.

If you require any more materials (posters & leaflets) please contact:

Paul Burton, Intermediate Care Project Support Officer, Doncaster CCG

Email; paul.burton@nhs.net

Tel: 01302 566020

Number 7

A Day in the Life of an Intermediate Care Professional

Lynette Coates, Hospital Avoidance Officer, AGE UK

It’s Monday morning and I get a call from the rapid response triage nurse. A gentleman that has been placed on the pathway over the weekend, following a fall, needs some assistance. He doesn’t need any personal care support but is struggling financially and doesn’t have very much food in the house. He has a daughter but she lives in Dorset. He has been given some equipment by the physiotherapist and although is a little bruised is able to manage his way around his home, but he doesn’t feel able or confident enough, to go out to the local shop.

I telephoned the gentleman to offer support, he was reluctant at first. He was grateful for what he had received over the weekend but didn’t want to bother anyone. I asked if it would be possible to pop and see him, just to check he was OK and have a chat with him about things. He agreed and later that morning I visited.

The gentleman had lost his wife seven years ago, he felt very low. We had a cup of tea and a chat, something that he was grateful for as he doesn’t see many people. We had a look in the fridge and cupboards to see what food he had in. He had a few items of food in the house, but nothing fresh. He had a small amount of money in, and I went to the local shop for him and got items such as milk, bread and

some cheese along with a couple of ready prepared meals for him to heat up later.

We talked about finances, and he told me that he was struggling to manage. He was finding it difficult to pay for his heating and didn’t know what to do over winter. The house was very cold and damp. I referred him to the DMBC Energy Team who arranged to come out and see him to see if there was any funding available, so that his boiler could be updated. I also referred him to the Age UK Doncaster’s Priory Place office so that they could carry out a benefits check and see if there was any financial support available. I also gave him some information on local befriending services, and social activities for when he felt better, as he had also said that he was

quite lonely. I arranged to ring him again in a few weeks to see how he was doing.

I attended the Rapid Response MDT later that afternoon. A lady who had come on the pathway late last week’s husband was struggling. His wife had refused support with personal care, and he was finding it difficult. I spoke to him in the afternoon, and he said that he had been managing his wife’s personal care, but he was worried about what would happen in the future. He had spoken to his wife and she had become a little more accepting of help over the weekend. I gave him information on the STEPS team at DMBC, and the telephone number for the DMBC Adult Contact Team. I also referred them for a Carers Emergency Card, which provides free support in the care of an emergency and is able to be used to fill the gaps between formal care as well, if her husband wasn’t able to because of illness. I also sent information on the Carers Service who provide information and emotional support for carers. He was very grateful of the information and said that it had taken a weight off his shoulders.

The Rapid Response project is still quite new, but it is clear that it makes a huge difference to the people using it as they have quick access to health and social care services which helps to reduce hospital admissions. I hope that it will continue.

Number 7

Staff working on Hawthorn and Hazel Wards have introduced a new initiative called “Colour Me Safe” in which all patients receive a coloured wristband after their initial risk assessment and care plan. The aim is to safely reduce falls risks on the inpatient physical health rehabilitation wards whilst also increasing patients independence.

The colour of the wristband is based on a personalised risk assessment and care plan and lets staff know how mobile each patient is at a glance. If a patient has a green wristband they are safe to walk alone, amber means they need help from a nurse, red means the patient is at a high risk of falling, while a blue one means they need support from two staff. The bands are given to patients as soon as they are admitted and assessed – and the colours can change as the patient engages in physiotherapy and occupational therapy during their stay.

Kate Priestley, introduced the idea after seeing an initiative which used stickers on walking frames to identify risks, however she knew she could expand this idea to help her patients, after she spent time talking to them and their families understanding what they want and need.

The initiative has made a difference and achieved the aim to help reduce falls and aid quicker and more appropriate risk management decisions.

Colour Me Safe Reducing Falls on RDaSH wards

Patients have also commented about the other improvements they have noted from the introduction of “colour me safe”. In the picture above there is Lillian (94) and Anne (76) who have both progressed through their recovery journey on Hazel Ward and now gained their green bands (seen holding them).

Lillian was admitted after a fall which resulted in a neck fracture, this made her frightened to walk which hindered her recovery, she also feared losing her independence and relying on others to move around. Lillian was provided with a red band on admission and started working with the ward staff as soon as she was able, she was “so happy” when she “achieved the green band”. She explained that she went from “needing someone with me to walk – to being able to do it on my own”, the ‘colour me safe’ system motivated her to ‘get home safely’ to celebrate her 95th birthday

Anne was admitted to Hazel Ward after she had a hip replacement she explained that from the start of her admission she has been focussed on ‘getting back to independence’ and that she ‘loved the band system’ because she is ‘competitive’ and it helped her think about different ways she could safely exercise each day in order to regain her independence. Anne is so pleased with her green band achievement she said she wants to take it home to remind her about what she can achieve.

Number 7

IT’S good to talk – as a new scheme is proving by saving Doncaster patients an unnecessary trip to hospital.

Consultant Connect is enabling GPs at the borough’s 43 practices to ring hospital specialists at Doncaster Royal Infirmary (DRI) for immediate advice about how to manage a patient’s condition, often while the patient is still in the consulting room.

They use a dedicated phone system which bypasses the main switchboard and ‘hunts’ across a number of phones in a department, automatically moving along if it reaches one that is either engaged or rings out for more than 20 seconds. Research suggests that GPs wait around one minute to reach a consultant and the average call lasts around four minutes - a big time-saver compared to writing and waiting for a reply.

“It helps us to make a good judgement on whether or not to refer a patient to hospital”, says Dr Stephanie Teanby-Clark, a GP at Askern’s Lakeside Practice.

“I recently contacted one of the chest physicians at DRI about a patient who is in her 90s and has breathing problems. The fast response I was given on how to manage her symptoms meant I was able to continue looking after her at home, which is what she wants, rather than sending her to hospital.

“Nobody wants to be referred to hospital only for the consultant to say that their GP is the best person to

manage their care. If the best course of action can be determined through a quick phone call it’s more efficient for the NHS and more convenient for the patient.”

The service launched in Summer 2017 and since then has been progressively rolled out across six specialty areas – paediatrics; orthopaedics; care of the elderly; ear, nose and throat; respiratory, haematology and acute medicine. Two more areas, Urology and Ophthalmology, joined the scheme at the end of January.

Crucially, reducing the number of unnecessary hospital appointments is freeing up more time for consultants to spend on the patients who need their experts. Dr Andrew Oates, Consultant Geriatrician at Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, said: “It’s an excellent system. Local GPs have contacted me with specific questions about patient care and this has helped avoid unnecessary referrals to hospital.

“Hospital is not always the best place to care for elderly people; we try to support their care at home where possible. That’s why it’s very useful to have this opportunity to talk through a patient’s condition with their GP first to determine whether they need to be admitted.”

Data is still being collated and processed but early indications are that the calls and advice provided are preventing admissions, details to follow.

Doncaster GPs and consultants agree it’s good to talk

New scheme benefits patients by avoiding unnecessary hospital visits

GP Referral Pathway Update and ClarificationDr Cheng Looi, Community Geriatrician, has recently been working with local GP’s to clarify the Rapid Response Service pathway. It sets out what is required from General Practice as part of and after the referral for the service to work safely and effectively. The pathway has been distributed to all Doncaster Practices and GP’s will soon be able to access the pathway on GP find. If anyone else requires more information please contact Dr Looi: cheng.looi@nhs.net

For more information on the GP pathway use the link here