Admission Avoidance (Rapid Response Team) Presenter: Karen Derrick Commissioning Manager Integrated Care team Camden Clinical Commissioning Group

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1 Admission Avoidance (Rapid Response Team) Presenter: Karen Derrick Commissioning Manager Integrated Care team Camden Clinical Commissioning Group

2 Admission Avoidance (Rapid Response Team) Background The Camden Local Care Strategy (LCS) established a strategic vision and direction for the whole system of health and care in Camden. This included the key whole system outcomes of: Reducing health inequalities Prevent early death Improve people s access to care Improve people s experience of care Enhancing people s quality of life The admissions avoidance programmes supports Camden s aim to deliver joined-up care, closer to home and improve the quality of care for those most in need alongside.

3 Admission Avoidance (Rapid Response Team) Background The Supporting People at Home programme, which provides the strategic framework for a system wide approach to admission avoidance in Camden, has a number of workstreams reporting into it where admission avoidance is a key outcome. The work falls into three broad categories: Increasing the capacity and improving the performance and effectiveness of rapid response services that seek to keep people in their homes; Targeting services at those groups who are most likely to be admitted to hospital; Enabling more people to receive a range of services (integrated where appropriate) in the community.

4 Admission Avoidance (Rapid Response Team) Current Service Camden Rapids service is a multi-disciplinary team comprising of senior nurses and occupational therapists, physiotherapists, a therapy practitioner and pharmacy provision. The team is managed by two clinical nursing leads. There is also access to a dietician and psychologist as needed. Rapid Response Admission Avoidance (RRAA): This service prevents unplanned avoidable admissions or readmission to hospital by providing care for people in their home, including in residential and nursing placements. The service supports those patients having an urgent and immediate medical crisis that, if not treated by the Rapid Response team, would require admission to hospital. The team operates from 8am to 9pm, 7 days a week

5 Rapid Response Team (CNWL) Rapid Response REDS PACE Discharge to Assess

6 Rapid Response Team Rapid Response PACE REDS Discharge to Assess 24/7/365 service to prevent hospital admission Clinical input for up to 10 days, with Carelink reablement, in patients own home 82% of referrals result in avoided admission: 74 referrals and 61 admissions avoided per month (average) Accepts referrals from a wide range of sources: 58% GPs 10% other community services 10% from acute hospitals 5% London Ambulance Service and others Referrals are received by phone and followed up with of up to date medical history or discharge summary

7 Rapid Response Team Rapid Response PACE REDS Discharge to Assess Assessment aims to occur within 2 hours of referral. We have a fleet of pool cars to assist with this. Ideal patients: chest infections, UTIs, cellulitis, falls, exacerbations of long term conditions Intervention: up to 10 days, nurse, occupational therapist, physiotherapist and pharmacist can be involved. Most nurses have ITU or A&E experience and some have an advance nurse practitioner qualification or are working towards Independent prescribers Integration with overnight nursing Falls service through therapist input Work with nursing, residential and extra care sheltered homes Links with community Heart Failure team and Respiratory teams (based in the same office)

8 General Practice Patient Participation Groups There is capacity for General Practitioners to refer more patients to the service. Can PPG s help us to promote the service?

9 Rapid Response Team

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