Consultation Terminology Care Homes Care homes can be categorised as either residential or nursing. Residential homes provide help with personal care only, whilst nursing homes also provide nursing care and must have a qualified nurse on duty at all times. Clinical Commissioning Group (CCG) Clinical Commissioning Groups (CCGs) are NHS organisations set up by the Health and Social Care Act 2012 to organise the delivery of NHS services in England. They commission most of the hospital and community NHS services in the local areas for which they are responsible. Commissioning involves deciding what services are needed and ensuring they are provided. CCGs are overseen by NHS England which retains responsibility for commissioning primary care services such as GP and dental services as well as some specialised hospital services. 1 South Devon and Torbay CCG is responsible for planning, designing and buying healthcare services for its local population. Clinical Hubs In each locality there would be a clinical hub providing people with better access to medical, clinical and specialist services. A clinical hub would offer a broad range of services to people and although one would be provided in each locality, they could be used by everybody irrespective of where people live. The clinical hubs would offer services such as outpatient appointments and specialist conditions clinics and inpatient services. By bringing services together in a single location we would reduce the need for people to travel to Torbay hospital for their services, therefore adopting the principle of care closer to home. The clinical hubs would be provided in buildings that are of a high clinical standard and where necessary additional investment would be made to improve the quality of environment and range of services offered. Community Clinics These would operate in health and wellbeing centres. They generally have more than 1,000 attendances a year and are mainly provided by locally based professionals, working across community sites. Examples of community clinics include MSK (Musculoskeletal assessment and treatment), speech and language therapy, podiatry. Domiciliary Care/Personal Care Services 1 NHS Choices website www.nhs.uk Page 1 of 5
Home-based personal care, usually on a long-term basis, provided by a private agency, regulated by the Care Quality Commission. These agencies help a service user stay safe and well in their own home. Support may include help with washing and dressing, meal preparation or prompting someone to take their medication. These are vital services to help more people to live independently at home for longer without the need for residential care or a stay in hospital. Support workers working for a personal care agency are not healthcare professionals and are not able to provide nursing support. Local personal care services are commissioned by Torbay Council and Devon County Council in partnership with Torbay and South Devon NHS Foundation Trust and the CCG. Health and Wellbeing Centres There would be a Local Health and Wellbeing Centre in Ashburton/Buckfastleigh, Bovey Tracey/Chudleigh, Brixham, Dartmouth, Newton Abbot, Paignton, Totnes and Torquay. These would see community staff based locally and working alongside GP s, pharmacists and voluntary sector organisations to provide health and wellbeing services to the area. Some Health and Wellbeing Centres would be located as part of the Clinical Hub. Health and Wellbeing Teams These teams would bring together in each locality an integrated team of community health and social care staff, mental health professionals and our voluntary sector partners to organise and deliver most of the health and social care needs of the population. They would work as a bridge between their GP services and the very specialist care that can only be provided in a large hospital like Torbay. Integrated Care Organisation (ICO) The single organisation responsible for acute and community healthcare in our area, known as Torbay and South Devon NHS Foundation Trust. It also provides social care for adults in Torbay. Intermediate Care A range of integrated services provided for a limited period of time to people who need extra support and care following a period of ill health. The emphasis of intermediate care is on active enablement. The aim of the intermediate care service is to: Support people at home when safe and appropriate to do so and thereby reducing admissions to hospital, reducing inpatient lengths of stay and reducing readmissions. Adopt a person-centred approach in which the individual takes on an active role to achieve maximum independence and quality of life. The intermediate care team supports the individual to set achievable objectives to help them attain their long term goals. Wherever possible the service will support people to remain at home throughout their episode of intermediate care. However, where this is not possible, a short-term care home placement is used to support the person and enable them to return home again, usually within twelve days. Placements are currently made to contracted homes, ideally located as close to the person s home as possible. Page 2 of 5
Enhanced Intermediate Care is built on the existing service model of intermediate care but enhanced and extended to ensure that it s able to be responsive to increased referrals. It includes additional medical and pharmaceutical input to support better outcomes for the patient. Long Term Condition A condition that lasts longer than a year, impacts on a person s life and may require ongoing care and support. Examples include diabetes, asthma, arthritis and chronic obstructive pulmonary disease (COPD). Long term conditions become more prevalent with age and older people are more likely to have more than one long term condition. Where a person develops more than one long term condition they are described as having multiple long term conditions. Lower Layer Super output Area (LSOA) LSOAs are geographic areas used by the Office of National Statistics (ONS) for census data and are areas that consist of between 1,000 and 3,000 people or 400 to 1,200 households. Multi Long Term Conditions Clinics These would provide a one stop shop approach to help people manage multiple long term conditions by accessing information and treatment in a single clinic. Minor Injury Units MIUs provide a local urgent care service in the community, filling a gap between GP services, the 111 service and A&E. They are intended to reduce unnecessary travel to the emergency department for non-life threatening injuries. Minor injuries units are an important part of the urgent care services by treating people with for example minor burns, sprains and fractured bones. Primary Care The health care and treatment given by a health provider who typically acts as the principle point of consultation for patients within the healthcare system and coordinates care with other specialists that the patient may need. This care is most often given by a patient s General Practitioner (GP) Secondary Care Healthcare services provided by medical specialists and other healthcare professionals who generally do not have the first contact with the patient. Usually secondary care services are provided in an acute general hospital such as Torbay Hospital. Self-Care Personal health maintenance. Any activity of an individual, family or community, with the intention of improving or restoring health, treating or preventing disease or maintaining existing good health. Page 3 of 5
Single Point of Contact (SPOC) A multi-media gateway to provide information and to mobilise relevant assessments and resources. Public and professionals will have a single point of entry into services across South Devon and Torbay with prompt and customer focused responses and minimal handover. The SPOC will divert activity away from statutory services, providing information and signposting to support self-care. Specialist outpatient clinics These would operate in clinical hubs and are clinics where patients currently travel further to access them. They would be mainly consultant-led and usually have less than 1,000 attendances a year. Some non-consultant-led clinics such as audiology require more specialist facilities or equipment. Examples of specialist outpatients might include: audiology, cardiology, dermatology, ear nose and throat, endocrinology, general medicine, general surgery, gynaecology, neurology, orthopaedics, paediatrics, rheumatology and urology. Torbay and South Devon NHS Foundation Trust (TDSFT) Torbay and South Devon NHS Foundation Trust was formed on 1 October 2015 through the acquisition by South Devon Healthcare NHS Foundation Trust of Torbay and South Devon Health and Care NHS Trust, creating an Integrated Care Organisation (ICO). This one organisation now provides acute care from Torbay Hospital and community services through a network of community hospitals, bases and people s homes and adult social care. Wellbeing Coordinators Wellbeing Coordinators would work closely with health and wellbeing teams and GP practices. They are employed by local voluntary organisations and connect people with the many activities and community groups that are available to address social isolation and help a person to maximise their independence. A strengths-based approach to practice will utilise guided conversations and self-management support tools. Bed Definitions Rehabilitation Beds: Beds for those recovering from a severe illness, who need to recover their health and mobility before going home, or for people who would be at risk if left at home and would benefit from rehabilitation care. Rehabilitation services are led by physiotherapists and occupational therapists providing intensive support with nursing and medical input as required. Intermediate Care Beds: The proposed new model of care outlines a proposal for investment in intermediate care, both within people s own homes and dedicated beds within local care homes. These will need to be procured within regulatory guidelines. Intermediate care services may be provided as step-up beds (intermediate care provided to a patient at home or in a care home as an alternative to admission to hospital) or step-down beds (intermediate care provided to a patient at home or in a care home following discharge from hospital). Page 4 of 5
Community Medical Beds: Beds for patients who need intensive, expert nursing care around the clock with medical input where needed, but who do not need the more intensive care and facilities of an acute hospital. They are also for patients who have been referred to the hospital by their local GP because they require medical or nursing input that cannot be provided in their own home or a local care home. Acute Care Beds: Acute care beds are beds accommodating patients where the principle clinical intent is to do one or more of the following: - Cure illness or provide definitive treatment of injury - Perform surgery - Manage labour (obstetric) - Relieve symptoms of illness or injury (excluding palliative care) - Reduce severity of illness or injury - Protect against exacerbation and/or complications of an illness and/or injury which could threaten life or normal functions - Perform diagnostic or therapeutic procedures Page 5 of 5