Enhanced Care At Home Dr Chris Stockport Deputy Chief of Staff, Primary, Community and Specialist Medicine CPG Localities Clinical Lead

What is enhanced care at home?  Prevents hospital admission by rapidly providing enhanced care to people in their own homes Reduces the length of time people spend in hospital by getting them home faster with enhanced care at home

Why do we want to provide enhanced care at home? It’s what most people say they want It reduces the risk of medically-related adverse events such as hospital acquired infections It supports the maintenance of independence and confidence Care can be provided safely and at least as well as if not better than in a hospital bed The person’s own GP is supported by staff from Health, Social Services and the Voluntary Sector who work together to provide 24/7 care in the person’s own home

What we’ve learned about Enhanced Care at Home Almost two years experience of successfully providing enhanced care at home in North Denbighshire has told us: Enhanced care at home is a credible and safe alternative to going into hospital (and coming home sooner) for a number of people with a range of medical conditions Where appropriate, enhanced care allows us to care for people at home so that they don’t get admitted to hospital simply because a better alternative at home isn’t available The people we’ve cared for, and their carers like it and both feel supported GPs and the staff who provide enhanced care like it too!

Taking Enhanced Care Forward Now starting to ‘spread’ enhanced care across North Wales, starting initially with four more localities – Anglesey; South Wrexham; Meirionnydd; and, Central/South Denbighshire. Aim to have started enhanced care at home in each of these four localities by Autumn 2012 The ‘roll out’ will then continue to be ‘spread’ to other areas in North Wales In each locality, enhanced care will continue to support GPs to provide more care for people in their own homes, with GPs working with staff from across health, social services and the voluntary sector working together to provide 24/7 care at home It supports the maintenance of independence and confidence Care can be provided safely and at least as well as if not better than in a hospital bed The person’s own GP is supported by staff from Health, Social Services and the Voluntary Sector who work together to provide 24/7 care in the person’s own home

Taking Enhanced Care Forward HOWEVER, THE ‘SPREAD’ OF ENHANCED CARE MUST BE BASED ON: An understanding of each locality’s particular needs and characteristics so that enhanced care at home reflects the specific needs of each locality. An understanding of what services already exist in each locality so that we can identify the best way of developing these further to provide enhanced care at home Involving staff from health, social services and the voluntary sector in each locality to ensure that enhanced care fits with their ways of working and the needs of each locality

Three Challenges = Three Opportunities Challenge of providing care in more rural areas, particularly in times of bad weather = opportunity to innovate, perhaps making greater use of technology Challenge of providing care 24/7 if required = opportunity to explore new roles/working relationships across health, social services and the voluntary sector Challenge of introducing enhanced care in the current difficult economic and financial climate = ensuring best use is made of all resources and potential to ‘re-allocate ’ funds out of acute hospital beds and into community settings.

Please Tell Us…. For your particular locality: What do you like about the development of enhanced care at home? What are your concerns about the development of enhanced care at home? What are the special needs of your locality that you worry we might miss? THANK YOU!!