by burylibdems on 21 November, 2017
Last week was the regular meeting of Bury Council’s ‘Health Scrutiny’ Committee. Councillor Mary D’Albert reports:
Delayed Discharge from Hospital
Delayed discharge is a high profile issue within the health service with significant knock on effect to other hospital services (e.g. lack of beds to transfer people from A&E). There is also a cost implication. It is reported that it costs over £1000 per night to keep a patient in hospital.
The two main hospitals that serve the residents of Bury – Fairfield and North Manchester – have introduced a new way of working. Both now have an IDT (Integrated Discharge Team). Staff in the team is drawn from both the health service and local authorities. Social workers from Bury are based at the hospitals. The team will operate 7 days a week (this did not happen in the past)
Patients in hospital from outside of the borough will be assessed by the team. In the past social workers etc from where the patient lived needed to access the patient. There are instances where a patient is ready to leave hospital, but the care home of their choice cannot accept them immediately. A ‘step down facility’ has been introduced.
The NHS has allocated community beds in care homes. The patient can be safely transferred to these care homes until the patients preferred care home is ready to accept them. This frees up hospital beds. The aim is that all hospitals in Greater Manchester will introduce this way of working, with a common standard.
Care Home Ambulance Pilot
A pilot scheme is being run in Bury by North West Ambulance service. The pilot scheme is being run at: Killelea House, Nazareth House, Abbeycliffe Care Home and The Heathlands.
Care homes have always been one of the highest callers of 999. However, there is acknowledgement that some 999 calls are for minor conditions or incidents which do not require an emergency ambulance. There were 1,746 calls from Bury care homes last year.
The plan is to introduce a new system into care homes that will help staff to identifying what kind of medical help is appropriate using a Nursing and Residential Home Triage (NaRT) Tool. This is a question and answer system that is designed to be used by care home staff (no medical qualifications are needed to use this tool).
The ultimate aim is to not only reduce the number of 999 calls, but increase the number of residents that are treated in the home.
Older people who are admitted to hospital are at more risk of:
– Reduced bone mass and muscle strength, approx. 2-5% per day
– Reduced mobility
– Confusion due to changes in normal routine and environment
According to recent statistics, the average length of stay in hospital following admission is 11.9 days. Appropriate alternatives to taking an older person to hospital should always be considered in line with the patient’s immediate and ongoing care needs. During the pilot phase of the NaRT, the triage tool was proven to reduce inappropriate conveyance of patients and potential admission to hospital by over 50%, with no adverse incidents reported.
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