GP Education and Training Event 9 December 2015 Dr Paul Kaiser Winter schemes 2015/16 Crisis Action Team (CAT) Frailty Assessment Base (FAB) Community Reablement Winter Beds 2015/16 GP Education and Training Event 9 December 2015 Dr Paul Kaiser

NON ELECTIVE EMERGENCY ADMISSIONS DELAYED TRANSFERS OF CARE Why do we need the Crisis Action Team (CAT), Frailty Assessment Base (FAB) and Community Reablement Beds? A&E ATTENDANCES The average number of A&E breaches per month over the winter period of 14/15 was 131 higher than those months outside of winter. January and February alone accounted for 27% of the yearly breaches. YTD 15/16 attendances are already up by 5% compared against 14/15 which could lead to a even higher level of breaches this year in winter. NON ELECTIVE EMERGENCY ADMISSIONS The average number per month in 14/15 over winter was 2,021 (10% higher than outside winter). YTD 1516 the average number of admissions is 1,970. If this increase continues into winter, IHT will have to accommodate an extra 150 emergency admissions per month. This is likely to then have an effect on length of stay and excess bed days. LENGTH OF STAY The number of patients who stay in for 3-10 days and over then days has risen by 5% and 4% per month suggesting that sicker patients are being admitted. ESCALATION BEDS The number of escalation beds open at IHT has increased significantly. In the first week of September, the average escalation beds open per day was 6 compared with 23 in the first week of December. The implementation of CAT/FAB will assist the flow of patients throughout the difficult winter months that IHT are about to encounter. DELAYED TRANSFERS OF CARE DTOC at Ipswich is currently exceedingly high. Ipswich’s performance each month varies between 4-5% which is well above the 2.5% average. This is due to changes in the Support To Live at Home contract and excessively high levels in community health.

Crisis Action Team (CAT) Hosted by IHT Core team of occupational therapists, physiotherapists, nurses, generic workers, social worker, CCP, voluntary sector link coordinator and support worker 24/7 service Referral via CCC and passed to CAT triage clinician based in CCC 2 hour response time for patients in crisis requiring multi agency response Short term intervention provided to manage crisis situation for up to 5 days Access to waking night care support SystmOne used to record patient information To make a referral: Contact the Care Co-ordination Centre on 0300 123 2425 and request the Crisis Action Team

Frailty Assessment Base (FAB) Hosted by IHT Consultant-led multidisciplinary service providing Comprehensive Geriatric Assessment for frail older patients at risk of acute admission Access to the service for GPs will be via a dedicated phone line Monday to Friday 9am to 5pm Based at Ipswich Hospital All patients will be seen within two working days or sooner based upon clinical need To make a referral: Contact the Interface Geriatrician Hot phone 07930 181236 or ihn-tr.FAB@nhs.net

Community Reablement Winter Beds   For winter 2015/16, I&ESCCG have commissioned 23 reablement beds as part of a six- month admission avoidance pilot to reduce avoidable emergency admissions by offering the opportunity for reablement care for patients in a community-based setting. Focus will be on ‘step up’ and ‘step across’ admissions Beds will be open until 31 March 2016 Location of the commissioned beds as follows: 6 x ‘’virtual’ beds at home (covering Felixstowe and Stowmarket area) 4 x beds at Baylham Care Centre, Ipswich 5 x beds at Alice Grange Care Home, Ipswich 8 x beds at Monmouth Court Care Home, Ipswich Consultant led MDT to manage the patients Patients placed in the community reablement winter beds will be deemed ‘medically stable’ with a low level reablement need or awaiting care packages. To make a referral: Contact the Interface Geriatricians (via the Frailty Assessment Base) on 07930 181236 for an initial clinical discussion and decision. Following the clinical decision, contact the Reablement Co-ordinators on 07930 175904 to co-ordinate the referral process