What does being a vanguard mean to you?
We are really proud to have been awarded vanguard status in recognition of the work that has been undertaken at Sutton CCG over the last few years. It has enabled us to pick up the pace in terms of improving the quality of life for our care home residents and the staff who work with them by providing training and support. Our vision is to ensure we have a vibrant, high-quality care home market in Sutton, delivering care that embraces the national nursing values of patient care (the six Cs): Care, Compassion, Competence, Communication, Courage and Commitment.
What problem did you want to solve?
There was a real mix of both quality and competency levels in our care homes, and local partners identified that many hospital attendances and admissions could be avoided if we invested in upskilling care home staff.
How did you go about it?
We initially adopted a three-pronged approach:
- Setting up a Joint Intelligence Group enabled us to take a strategic view on quality assurance and identify training and support needs by analysing data and sharing intelligence and data sources with our partners.
- Establishing care home forums for managers and staff to help us understand the issues they face and for them to tell us what support and training they need.
- Designing training and support packages, delivering these and ensuring they are embedded into everyday practice.
The award of Vanguard status has really brought health and social care partners together in Sutton. We’ve been able to be more innovative in our approach and tackle barriers to success, dispel myths and focus on what really counts – delivering great care.
It has also enabled us to not only design and implement new ways of working but to also share innovative practice that makes a difference with others across health and social care provision.
What has the reaction been and what has the level of staff engagement been like?
Sutton as a whole is so proud of the work with the Vanguard and everyone is keen to get involved and support the programme.
How would you explain the way your new care model works to members of the local community?
The way our model works is to put care home residents, their families and care home staff at the heart of the model of care. We work together with our partners and test our model of care with people who will deliver and receive the care, taking their skills, experience and expertise on board.
What is already having or what is going to have the greatest impact and value for patients as a result?
We have already seen a year-on-year reduction in call outs for ambulances, which has had a positive impact on hospital attendances and admissions. Staff feel more skilled and confident, changes in residents are identified and treated earlier, reducing the occurrence of acute episodes.
Do you have any great case studies that immediately spring to mind or can you tell me what your most satisfying day at work has been since becoming a vanguard?
We have many great case studies! The most satisfying piece of work we have delivered so far is the Hospital Transfer Pathway, known affectionately as the Red Bag Initiative, which we launched to care home managers at our Care Home Forum in November 2015. The Hospital Transfer Pathway stemmed from one of our Care Home Forums in August 2015 where a geriatrician from our local hospital, Epsom and St Helier University Hospitals NHS Trust, came to talk to care home managers about looking after older people. It’s a brilliantly simple initiative that helps care home residents receive quick and effective treatment should they need to go into hospital in an emergency.
The Red Bag contains standardised information about the resident's general health, any existing medical conditions they have, medication they are taking, as well as highlighting any current health concern. This means that ambulance and hospital staff can determine the treatment a resident needs more effectively. It also has room for personal belongings (such as clothes for day of discharge, glasses, hearing aid, dentures etc) and it stays with the patient whilst they are in hospital. When patients are ready to go home, a copy of their discharge summary (which details every aspect of the care they received in hospital) is placed in the red bag so that care home staff have access to this important information when the resident arrives back home.
The Red Bag also clearly identifies a patient as being a care home resident and this means that it may be possible for the patient to be discharged sooner, because the care home has been involved in discussions with the hospital and has an understanding of the residents care needs so they are able to support the resident when they are discharged.
What do you think has been the most difficult challenge or barrier to overcome?
The biggest challenge has been managing the levers to ensure that change happens. Without contractual measures or regulations in pace, we work on a goodwill basis with our care homes and the changes and uptake of our resources and training are achieved through engagement.
With high numbers of our care home residents being self-funders, there is not an NHS contract to provide this lever.
Vanguards are leading on developing new care models that will act as blueprints for the future of the health and care system in England. What advice would you give to anyone looking to adopt your new care model?
First and foremost, engage with partners, including the care homes: they are an important part of our health and social care landscape, therefore they must be involved in every part of the design. It’s about developing relationships, trust and co-operation.
How are you sharing learning?
Posters, training films, bulletins and press releases have been produced by the Vanguard team and their partners to promote, communicate and engage with staff from care homes, the London Ambulance Service and hospitals. In addition we are currently updating our website, which has full details of our work to-date, including many case studies which have been written up to enable shared learning. We’ve had open days, held webinars and will be hosting a joint conference with HIN (Health Innovation Network) and the Academic Health Science Network (AHSN) for South London in October.
What do you think your vanguard and the service it delivers will look like in 12 months’ time?
In 12 months from now, I think the elements of our vanguard will be embedded into business as usual within our care homes, and we will be able to demonstrate measurable example of how this has benefitted patients. Some of this innovation has been adopted by other areas in England and we would hope they also become normal working practice in those areas.
From your work so far, what's your one top tip (or learning) that you could share right now with us, that we could learn from and implement within our work areas?
My one tip is – don’t be afraid to do things differently. Be creative and work together to design new ways to improve patient care.
I really appreciate Sutton CCG Vanguard taking the time to tell us about their work - I'm a great fan - no not just because I love handbags!!! - but you can read more about the fabulous Red Bag initiative here http://fabnhsstuff.net/2015/12/17/the-blonde-loves-this-red-bag-suttonccg-vanguard/