Senior officers from Havering CCG and North East London NHS Foundation Trust will update the Sub-Committee on intermediate care in Havering including the Community Treatment Team and Intensive Rehabilitation Service.
Minutes:
It was explained that the CCG wished to move more care closer to home and have less reliance on hospital-based services. To this end, two new services – the Community Treatment Team (CTT) and Intensive Rehabilitation Service (IRS) had been introduced and proven a major success.
The NELFT representative confirmed that the CCT provided a rapid response to patients in crisis or to facilitating discharge. The CCT comprised doctors, nurses, physiotherapists and occupational therapists who provided short-term support to patients in their own homes. The service was available 8 am – 10 pm, 7 days per week.
The IRS offered support from physiotherapists, occupational therapists and nurses in people’s homes 7 days per week, 8 am – 8 pm. The service normally responded to a referral within 24-48 hours.
The CCT dealt with around 1,600 Havering referrals per quarter. This was approximately 55% of the tri-borough service and reflected the older population within Havering. 93% of referrals to the service were seen in their own homes and patient feedback on the service had been very good. The service had also reduced levels of demand on A & E. It was confirmed that a care plan was established for each patient and this was referred to by staff each time a patient was visited.
The IRS received 280-300 Havering referrals per quarter, around 50% of the total service. 98% of patients had been found to improve during this treatment and length of stay with the service had increased 7 to 15 days on average. Regular surveys of patient experience were undertaken and patient feedback had been very positive for both services.
As regards system resilience, both services contributed to winter planning. The CCT had established with the London Ambulance Service a falls car whereby a paramedic and CTT nurse visited people who had fallen at home. It was considered that one falls car was currently sufficient to cover the three local boroughs but any increase in the service would be considered by the system resilience group. The service was currently available 7 days per week, 12 hours a day.
The services had received national recognition, being shortlisted for the Health Service Journal awards and requests to view the work undertaken had been received from Finland and the Netherlands. Future plans included the integration of services at the front door of A&E such as older persons’ services and ambulatory care. It was planned to co-locate beds at King George Hospital but this was still being finalised with BHRUT and would be brought to the Sub-Committee in due course. Concerns about the change of services that had been raised in Redbridge were being addressed.
Seven per cent of patients seen were not able to be treated at home, often because their conditions too complex. Patients would be admitted to hospital if this was found to be the situation.
It was noted that the services did not cover the neurological pathway and were fort more routine conditions rather than specialist areas e.g. multiple sclerosis. Time spent with patients was not limited and CTT and IRS staff stayed with patients as long as was necessary, depending on a patient’s need.
There were approximately 43 WTE staff on each team but officers would confirm this. There were currently four vacancies at the CTT and none at the IRS. While five locums were used overall, there was little staff turnover in either service.
The Chairman of Healthwatch Havering confirmed that the organisation strongly supported both services, feeling they provided excellent treatment and gave a voice to the elderly and most vulnerable people in the community.
The Sub-Committee NOTED the update and the work of the two services.