North Lanarkshire is the best council area in Scotland for ensuring patients are treated at home rather than hospital.
That was the key message from a report heard by the North Lanarkshire Integration Joint Board (IJB) on Wednesday, 09 December.
The board members heard North Lanarkshire has the country’s largest percentage of people aged 18 and older with long term needs receiving personal care at home. They also heard the area has one of Scotland’s lowest rates of people living in care homes.
Health & Social Care North Lanarkshire (HSCNL) carried out a public engagement exercise which showed peoples’ top three priorities were being in control of the care they receive and it meeting their needs; being supported to maintain independence and manage their care needs; and being supported and helped to avoid preventable conditions.
A number of key initiatives are playing a role in ensuring that residents are supported to live independents lives at home as long as possible. These include:
- Planned Date of Discharge
- Integration Rehabilitation Teams
- Home Support
- Self-Directed Support
- Hospital at Home
Planned Date of Discharge ensures more people receive a planned date for discharge as early in their hospital journey as possible. The focus is on fully integrated person-centred care in local communities rather than staying in hospital when medically fit for discharge.
Currently being piloted across three wards in University Hospital Wishaw and two in University Hospital Monklands, the initiative has seen the number of people in hospital medically fit for discharge falling from 120 in August to 65 people in October.
Also playing a key role in delivering more treatment in the community and helping people remain at home are the Integrated Rehabilitation Teams. These multidisciplinary teams comprise of North Lanarkshire Council and NHS Lanarkshire physiotherapists, occupational therapists and therapy assistants. The teams deliver a range of specialist rehabilitation treatments to enable the best outcomes for service users’ wellbeing.
The teams support early discharge planning from hospital or, where possible, help avoid hospital admission altogether. The work is designed to shift the balance of care towards the community with the teams having direct access to Hospital@Home.
In addition, the introduction of Near Me clinics has been hugely beneficial for the service, enabling non-urgent referrals to be assessed and managed effectively. This has reduced waiting times and numbers, and further hospital admissions.
The partnership is currently progressing with the implementation of the second phase of the new Home Support model, which will see the introduction of electronic dynamic scheduling. This system is anticipated to create an efficiency boost of up to 20%, creating additional capacity for assessments, reviews and meeting increasing demand.
The first phase of this work ensures referrals for new or increased care packages can be delivered with up to 12 weeks of support to maximise independence before moving towards any ongoing care package. As a result, more than 45% of those required no ongoing package of care at the end of the 12 weeks and a further 30% required a reduced package of care.
The North Lanarkshire approach to self-directed support ensures people have as much choice and control as possible to achieve the outcomes best suited to their needs. The approach is based on promoting independence, social inclusion and minimising reliance on paid support. It is based approach to people’s own abilities, interests and strengths; it recognises the importance of people’s own social capital with family, friends and relationships being one of the most important factors in people’s lives.
Hospital@Home provides acute care within the patient’s own home, with a commitment to be in the patient’s house within an hour of referral. Patients can be referred for hospital investigations as though there are in a hospital bed. Any rehabilitation or further support is arranged in the house. Patients are discussed at a daily multi-disciplinary team meetings until discharge back to their GP. The service provides 64 virtual beds across Lanarkshire and supports over 250 referrals per month.
Dr Avril Osborne, chair of North Lanarkshire Integration Joint Board, said: “It is wonderful that we are helping so many people avoid hospital admissions and are receiving care in their own homes instead.
“This what they are telling us they want and we’re dedicated to meeting their wishes. We know they want to live full and active lives at home while minimising hospital stays.
“By listening to their feedback North Lanarkshire is now the country’s best performing area in helping our residents meet this goal.
“This work to meet the needs of our residents is very encouraging. We are dedicated to delivering the services people tell us will benefit them and this is clearly reflected in the number of people receiving care at home in line with their wishes.
“In partnership with stakeholders and the independent and voluntary sectors we are building a range of programmes which support the prevention, early intervention, community capacity building and wellbeing agendas across North Lanarkshire.
“We are on a journey in North Lanarkshire to ensure we are developing our services and supports to enable people to live as long as possible not just within the community, but connected to the community. This is what people tell us they want and we are dedicated to helping them realise these wishes.”
Councillor Paul Kelly, vice-chair of North Lanarkshire Integration Joint Board, added: “Across North Lanarkshire we have made significant progress in supporting a positive balance of care. We aspire to develop this further and the range of programmes showcased today are central to achieving the ambitions set out within the Strategic Commissioning Plan.
“This way of working builds more inclusive, cohesive and resilient communities which reduce future reliance on statutory agencies and services.
“It’s important to record our thanks to all the people who have made such a positive contribution in tackling problems at the root and equipping people to lead better, more independent lives.”