Mr George Briggs, Associate Director for Medicine and Mrs Gill Adamson, Associate Nurse from UHNS and Alison Ansell RGN, Clinical Design Consultant from Health Care at Home will be in attendance.
The following questions have already been raised by the Chair:
Why was this Service Provider Chosen?
How is the Service Provider Monitored?
The Costs involved
The number of patients involved
Has the CCG signed this off
The nature of medical conditions suitable for the service
Minutes:
A brief summary was distributed. Mrs Gill Adamson (Associate Nurse from UHNS) explained how the UHNS launched UHNS@Home service on the 20 January 2014 to give patients the option to complete their hospital treatment in their own home for the first time, receiving care from nursing and therapy staff under the guidance of a UHNS Consultant.
Patients remain under the care and responsibility of a named Consultant at UHNS until they are ready to be discharged.
It was acknowledged that patients treated in the comfort of their own home tend to recover quicker, are less likely to be readmitted into hospital and are less likely to acquire infections during their recovery.
It is planned to roll out to additional surgical specialities during May 2014.
Mr George Briggs (Associate Director for Medicine) explained it will be a ‘test and learn’ contract for three years and can cease/change if required. There will be extensive monitoring of performance. Presently there are seventeen patients.
The Civil Contingency Group have formally signed the plan off. There is a very different cohort of patients, these are not medically fit to use Civil Contingency Group facilities but are working closely with the Civil Contingency Group.
Alison Ansell (RGN) advised it is a multi-disciplinary team with a twenty four hour care bureau. Family/carer can ring regarding any concerns of a patient. The patient is under the care of a Consultant. There is a very robust assessment process with a seven day a week service, intravenous antibiotics, wound care, patients waiting for surgery, patients waiting for a package of care who are awaiting a start date.
A Member was in agreement that patients do recover better at home with more eligibility, home assessments, lay Members on the Board, twenty four hour care bureau night provision provided. Alison Ansell explained that each speciality must meet with clinicians as clinical stability is paramount. The inclusion criteria is specific to each speciality. Staff talk to the patient/speak to the family regarding going home. Any concern regarding the home environment the team go out to assess. There is always a ‘settle in’ visit on the first evening.
It was asked how the service provider is monitored. The Associate Nurse from UHNS advised home assistance does not replace existing community services. If the Consultant felt the patient’s home environment is not suitable, for example not safe cooking, no other services available and the patient will not be safe the patient will not go home.
Standard monitoring is carried out during home visits; blood tests, blood pressure which are all documented electronically for the Consultant to view on a daily basis.
The Consultant carries out home visits but cannot visit all patients.
Concern was raised over recruitment. It was reported back that there is no concern surrounding this issue.
UHNS covers North Staffordshire, Stafford, Eccleshall, Market Drayton and Shropshire. Stafford is where many patients are remaining as in-patients and not having the support to be at home.
A KPI report is discussed at UHNS@Home Operational and Project Board meetings.
There is a clear complaints process with the standard complaints process as per UHNS. Satisfaction Survey forms are quite detailed and patient stories are starting to be collated, with assistance being provided to the patient completing the form especially the elderly. They are part and crucial to the assessment process.
It is hospital policy to test patients of a certain age for dementia. UHNS does not currently include people with mental care issues as currently there is no expertise.
A Member asked if the UHNS commission beds in nursing homes as this service could be utilised. The Associate Director for Medicine confirmed UHNS does not commission any care home services.
The UHNS Officers were thanked for attending.