Fire service as an asset: providing telecare support in the community Webinar 11th March 2016

Editor's Notes

• #9: How many appointments are currently provided across Coventry? Is there a view on unmet demand? How many email vs telephone vs tele-conferencing appointments would be made available? How many appointments would be offered per hour What are the numbers of patients attending A&E as a result of not being able to get an appointment with the GP
• #12: How many appointments are currently provided across Coventry? Is there a view on unmet demand? How many email vs telephone vs tele-conferencing appointments would be made available? How many appointments would be offered per hour What are the numbers of patients attending A&E as a result of not being able to get an appointment with the GP
• #13: How many appointments are currently provided across Coventry? Is there a view on unmet demand? How many email vs telephone vs tele-conferencing appointments would be made available? How many appointments would be offered per hour What are the numbers of patients attending A&E as a result of not being able to get an appointment with the GP
• #14: How many appointments are currently provided across Coventry? Is there a view on unmet demand? How many email vs telephone vs tele-conferencing appointments would be made available? How many appointments would be offered per hour What are the numbers of patients attending A&E as a result of not being able to get an appointment with the GP
• #16: How many appointments are currently provided across Coventry? Is there a view on unmet demand? How many email vs telephone vs tele-conferencing appointments would be made available? How many appointments would be offered per hour What are the numbers of patients attending A&E as a result of not being able to get an appointment with the GP
• #19: 5 Year Forward……….need of enhancing prevention work around health through a combined approach between emergency services and NHS. Simon Stevens (Telegraph 29/01/16). “The NHS has a golden opportunity to piggyback off the fire service’s vital 670,000 home-safety visits, to help prevent falls, broken hips and hospital admissions. Bed blocking is causing a huge strain on the NHS, with over a million hospital bed days lost in England because of delayed discharge each year. Over the past 14 year, he said, there has been a 124% rise in admissions to hospital for one day or less which cannot be explained simply by an increase in the number of old people.
• #20: Carter Report February 2016 …….identifying how trusts can best cooperate tactically with other health and social care partners within their local health economy on a daily cycle of early and proactive transfer out of hospital;
• #21: Distribute resources to achieve 5 min attendance Blended Fleet PRL/BRV Max 10% emergencies 40% Prevention now 40%+ due to reactive interventions
• #22: Environment Check Heating Cold Alarms Lighting Food Access to toilet Access to phone Wellbeing Helping to support the individual return to their home by giving reassurance Checking Safety/Security to give confidence Any safeguarding issues (neglect / abuse) Social Prescribing Reassurance to hospital / local community health teams The fires service is an additional control measure that allows for confidence in the discharge of the patient Feedback is given which will support the service user receiving the appropriate and timely services from the health partners. Referral As part of our normal safe and well check referrals will be made to local partners Try to limit referrals to build capacity in the health system
• #23: This film clip shows the work of 2 of our approx 100 VPOs Firefighter Andy Hobday working alongside Age UK in Coventry and Solihull And then FF Ian Sturmey working with the homeless in Birmingham Pete will now address the 3 issues regarding Public Health Policy Links to local commissioners And supportive environment to develop and deliver our health interventions
• #24: Starting point Perfect Week – University Hospital Coventry and Warwickshire (UHCW)           (Safe and Well Check at a set time - Urgent) During University Hospital Coventry and Warwickshire (UHCW) perfect week the West Midlands Fire and Rescue helped and supported patients who were discharged from hospital (including ED). This service was to support a speedy and timely discharge and to reduce readmission.   UHCW are ran a perfect week 11th -19th November 2015 where they looked to increase the efficiency in the running of the hospital. This will be done by piloting new innovative projects. One area they concentrated on was increasing the number of hospital discharges from the emergency department. This is to enable the hospital to increase the number of available beds for future admissions.   In the past, vulnerable individuals have remained in hospital due to the unknown environment and risks that they will be going home too. (Gary you need to be aware that a clinician will not admit to this, patients only stay in hospital due to clinical reasons). As a result the hospital have waited for services to become available in order to facilitate patients return home which has created greater strain on hospital resources.   As a pilot for these 8 days we supported hospital discharge by providing a Safe & Well check to vulnerable individuals as they arrive home. This also included additional information that the hospital wished to clarified. This will provide greater reassurance to the hospital about the individual’s home environment and will help prevent the patient not being re-admitted back into the hospital. We only had one referral during the prefect week from the hospital and carried out one visit. Nationally this is known as a Perfect Week exercise and locally it is being called “Breaking Free for our Patients”.  These exercises have been successfully used by many health economies to improve the way patients move through the healthcare system. For one week, all the organisations involved will be making changes to improve the experience for patients and better understand the reasons behind any delays in them being able to get back home. During perfect week, the organisations involved are planning to work differently to deliver the following: More than 100 non-clinical staff across the organisations involved will be volunteering as Ward Liaison Officers for a week to help resolve issues stopping patients from being discharged when they are well enough. Increasing the access to the existing ‘falls pathway’ initiative which creates additional support in the home of someone who has fallen often, meaning they do not need to go to hospital or are discharged much quicker. Ensuring access to a GP to help with discharges in a pilot on one ward of University Hospital. All partners are working with UHCW to look at ways to simplify the ways that patients are discharged. Health and social care partners are working with UHCW to extend their multidisciplinary service to help frail and elderly people who have fallen at home to patients who present at University Hospital’s Emergency Department.
• #25: Situation 87 year old lady fell over in Coventry Market and was admitted to hospital with minor injuries. Hospital couldn’t contact family to ensure safe discharge and had no clinical reason to admit patient Discharged with pain relief and additional control measure of a fire service visit Fire service mobilised through fire control and arrived 10 minute after the individual arrived home On arrival Patient was very agitated and uncomfortable House was in very good condition with lighting and heating Wanted to make contact with family Unsure of when and how often to take her pain killers What the fire service did Help was given with her mobile phone to enable her to use it. (additional numbers / font) Son called during visit and the crew explained what had happened and reassurance was given Individual uses her notice book to help her remember so crews repeated her medical schedule in the book Advice was given to take documentation with her the Monday morning GP visit and if pain got worst contact 111 Reaffirmed hospital advice around rehydration Feedback Mrs V was left feeling comfortable and happy after talking through her concerns Family members were confident with are actions following phone call (fire service branding) Feedback report was given instantly via stop message through fire control
• #26: Situation 85 year old lady being discharge from hospital and has dementia (no other information received) On arrival Crews attended at the agreed time (1 hour from her discharge) (all information capture in a incident log) Crews enter through back door which was open and unsecured where they found her lying on the floor Mrs P was unable to get up and was very cold Front room fire was left on full Mrs P was unaware of her hospital visit and what had happened since she had got home What the fire service did Mrs P was assessed for injuries Was made warm and comfortable by moving her to the front room and reassured by the crew Mrs P was still very confused and had little mobility Ambulance was requested who decided to take Mrs P back to hospital Feedback Fire Service has complete a report and recommended the following; Joint visit with care and VPO Falls assessment to be complete Telecare equipment to be installed Positives Even though this was a failed discharge the fire service provided a control measure which worked and ensure the safety of Mrs P through a timely response. This will allow for greater confidence in future discharges knowing that a guaranteed visit will take place in the home environment in a timely manner.
• #27: Potential End of life