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Holistic Assessment Rapid Investigation

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Presentation on theme: "Holistic Assessment Rapid Investigation"— Presentation transcript:

1 Holistic Assessment Rapid Investigation
HARI Holistic Assessment Rapid Investigation

2 HARI Definition A multidisciplinary community service for adults with complex medical and rehabilitation needs

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4 HARI Vision Keeping people well Prevent unplanned hospital admissions
Reduce the risk of falls Enable independent living Rehabilitation  

5 Referral Criteria Patients: registered with a Merton GP
aged 18 years + requiring therapeutic intervention from more than one health professional including: Consultant Physician; Advanced Nurse Practitioners; occupational therapists; and physiotherapists. Pharmacist – coming soon! with mental capacity to participate in group and individual based rehabilitation Complete single referral form SMCS website – tick “HARI”or “rehabilitation” Provide information to outline anticipated patient outcomes and choose an appointment with an appropriate health professional if known Transport can be offered for those unable to travel independently

6 HARI Referrals The referrer can select a choice of 2 service options:-
A full assessment by the whole team including a full Consultant/ANP assessment, plus therapy assessment, falls screening and rehabilitation. For this pathway, referrals can only be made by the GP 2. For those requiring rehabilitation only, referrals can be made by GPs but also directly from SMCS rehab teams e.g. Rapid Response, Falls Prevention Service and also, if appropriate, patients with Parkinson’s Disease will automatically be reviewed on a 4 – 6 monthly basis team Patients will be offered a routine appointment within 10 working days

7 Meet the HARI team Consultants Physicians Advanced Nurse Practitioners
Nurses Health Care Assistant Occupational Therapists Physiotherapists Rehabilitation Assistants Administrators Pharmacist – coming soon Podiatry – Regular sessions

8 Assessment and Investigation
The team will provide assessments, request investigations and formulate management/ care plans Holistic – reviewing patients, carers and their needs With Advanced Nurse Practitioners, consultants, physiotherapists and occupational therapists Investigations, as required, can be organised during the initial visit or with subsequent visits

9 HARI Rehabilitation Based at the Nelson Health Care Centre
Assessments are carried out at the Nelson and therapists also assess in patients’ homes. Patients have the option of a morning or afternoon session On arrival patients are offered a hot drink and have their nursing observations before commencing therapy AM therapy sessions start from 9.30 – 11.30 PM therapy sessions start from – 15.30

10 Rehabilitation: Occupational Therapy
Full Occupational Therapy Assessment – seeking to promote independence at home and within the community. Home Assessments to assess an individual’s functional ability within the home to assess for home hazards and reduce the risk of falls. Prescription of specialist equipment to promote independence Wheelchair assessments and practice Moving and Handling Risk Assessments Upper limb and Hand Assessments and hand rehabilitation Orthotic Fabrication Cognitive Assessment Anxiety Management Training, psychological support and the promotion of wellbeing and healthy lifestyle choices Health Promotion and advice for patients and carers

11 Rehabilitation: Physiotherapy
Full Physiotherapy assessment including balance, strength, mobility and falls assessment. Gait assessment and re-education including outdoor mobility practice Provision and review of walking aids Individual and group exercise within gym environment Home assessments to review mobility Home exercise programme Onwards referrals to Falls Prevention Service and Community Support Services

12 Falls Service Provision
Three key teams provide the SMCS Falls Service Holistic Assessment & Rapid Investigation (HARI) CRISIS/Community Rehabilitation Team Falls Prevention Service (FPS) PLUS Other Falls Pathway Teams Community Neuro-Therapy Team (CNTT) Rapid Response Team (RRT) Community nursing

13 External Collaboration
HARI Secondary Care-Specialist Teams Mental Health General Practice/ Primary Care staff Dementia Hub Social Services The Voluntary Sector

14 Internal Collaboration
HARI Community Rehabilitation Team Community Nursing Teams Community Prevention of Admission Team Continence Service Speech and Language Therapists Falls Service

15 Patient Example

16 Future Innovations New HARI pharmacist to support medicines optimization Improve links with Mental Health Services including links with new Dementia Nurses Currently recruiting 2 new Occupational Therapists to link in with the above and 1 new Physiotherapist.

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18 Contact details Referral Queries- Adult Referral Centre HARI Queries –
HARI – Holistic Assessment Rapid Investigation Contact details Referral Queries- Adult Referral Centre Sutton and Merton Community Services Administration Centre Tel: HARI Queries – to speak to a clinician HARI Nelson Health Centre Kingston Road Raynes Park London SW20 8DB Tel:


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