The principle value proposition was to improve the health and experience of local populations by developing patient-centred leadership; staff working with patients and communities to develop locally-led, innovative solutions that improve the equity, quality and efficiency of emergency and urgent care.
Following publication of the Five Year Forward View and Emergency and Urgent Care Review, an additional challenge for regional ambulance services is achieving strategic alignment and flex across a range of locally designed integrated models of care, which are beginning to emerge.
The aim of the project is to:
• Improve the health and experience of patients
• Provide safe care delivered closer to home
• Reduce 999 demand and unplanned hospital admissions
There are now 12 CSP schemes in operation across the NW: • Cumbria - Millom, Workington, Barrow • Lancashire - Skelmersdale, Pendle, Fylde • Greater Manchester - Partington, Chorlton, Glossop • Cheshire & Mersey - Alsager, Knutsford, Aintree
All twelve schemes are now supported by a co-hosting arrangement with a local GP Practice, Out of Hours Provider or Community Trust. This is underpinned by an Honorary Contract, which enables them to undertake clinical practice within different carer settings – adding extra capacity and supporting the development of local integrated care delivery models. Each of the schemes is also underpinned by a locally developed Community Delivery Plan, which sets out their core activities for this financial year. These are based on local priorities and population needs, which are wide ranging given the diversity of the selected communities.
An improvement–based approach has been used to structure the planning, measurement and evaluation of the project. As a result, we have been able to identify common themes that have emerged from the planning, which have been captured using a driver diagram.
Some of the key developments to date include:
1. Development of a Triage tool for Nursing Homes - designed to enable Nursing Home staff to assess patients before deciding whether to call 999, with alternative pathways for lower acuity patients.
2. Working with GP Practices to help either; reduce hospital admissions activity or improve the distribution of admission activity across the day, including providing more prevention-based interventions for patients.
3. Deployment of a telehealth monitoring and health coaching with a technology partner for post-discharge and LTC patients.
4. Development of a skin tear pathway to enable patients with minor skin tears to be treated at home.
The CSPs have undertaken a significant amount of local engagement activities with external stakeholders. This has included attending local schools, providing CPR training, and also helping secure investment for additional defibrillators in the community.
Each of the CSPs write blogs about their work. These can be found via the following link: http://www.nwas.nhs.uk/careers/a-week-in-the-life-of/#.VhUAkexVhHw
An evaluation method for the schemes is currently being developed. However, we have already seen a 16% reduction in ambulance journeys in one scheme.