Buckinghamshire Healthcare trust has been operating Community Hubs since April 2017. These facilities were launched to provide a Community Assessment and Treatment Service (CATS) for frail people, Outpatients Services, Diagnostics and links to third sector organisations, closer to patients’ homes. The hubs replaced community inpatient beds, and have provided better care, better use of resources, and reduced strain on acute services.
Why we needed to innovate.
Predicting and meeting the health needs of the population is a challenge, but we know that
1. we have increasing and ageing population;
2. the population want care closer to home.
With the traditional primary and secondary service under pressure; the only services in the county able to meet the needs of frail patients were disparate and fragmented.
Developing a Solution.
The Community hospitals in Thame and Marlow contained 20 beds between them, and it was hard to say with certainty that that this was the best use of resources for our patients. The wards were frequently occupied by for patients waiting for care home spaces.
So we involved local stakeholders to understand what a good service would look like, and we looked at the cases for change made by other areas that had faced similar challenges to Bucks.
We couldn’t develop a new service on our own, and the patient stakeholder groups which were formed to advise the development of the hubs are still very active today. In fact, a member of one of the group who is a retired GP, recently said that he has
“...never known hospital managers, clinicians and the community work together so well to create a new service”.
A sustainable service; exceptional patient experience; improved outcomes.
The Hubs provide a rapid access service which enables frail patients to obtain a diagnosis and treatment closer to their homes, and seek to reduce the burden on local GPs and district nurses. And access is simple: We take online referrals and there is also a single phone number which GPs can call either to refer a patient or to obtain advice.
One of the key things that our patients value is the amount of time that we dedicate to each patient, so much so that patient feedback includes
“I would march to keep this service open”.
Of course, time is money, but commissioners acknowledge that we are ‘spending money now to save it later’: we can arrange for patients and their families to be with us for several hours to discuss their long-term conditions, prognosis and how to manage their condition which doesn’t result in them crash-landing in A&E or an acute bed. This approach seems to be working when you look at the re-presentation data.
The hubs now are growing, with more services being added all the time, with community OP services, other organisations such as Citizens Advice Bureau, or new ideas such as the ‘Big Conversation Café’ where patients or carers can meet professionals in an informal setting to discuss subjects such as end of life care, or dementia