A national study by the Improvement Analytics Unit published today, 31 March 2017, shows that an enhanced package of support is likely to be a key contributing factor in reduced A&E attendances and hospital admissions from Rushcliffe care homes.
The Improvement Analytics Unit (IAU), a new initiative between national partner organisations the Health Foundation and NHS England, focused its first statistical evaluation on assessing the impact of the enhanced package of support provided by Principia.
Comparing data from Rushcliffe care homes against data from similar care homes elsewhere, the study found that those receiving Principia’s enhanced support model of care attended A&E 29% less frequently than similar care home residents in other parts of the country and were admitted to hospital 23% less often.
The IAU evaluation compared the health outcomes of 588 care home residents in Rushcliffe’s 23 care homes with a control group of 588 care home residents living elsewhere in the country who had not experienced an enhanced care package.
However, in all other respects the two groups were carefully matched to ensure they were as similar as possible, including in age, gender, ethnicity, socioeconomic deprivation, health conditions and the type of care home they lived in.
The Health Foundation says the positive results in Rushcliffe are likely to be the result of higher quality care being provided in the care homes but cannot be certain which aspects of care are responsible for these comparatively positive results.
Hosted by NHS Rushcliffe CCG, Principia was named as one of 50 national ‘Vanguard’ sites in 2015 as part of NHS England’s New Care Models programme. It has since received two allocations of national funding to support local innovation in health service redesign, including its enhanced support to care homes initiative.
Principia’s enhanced care package for care includes having a designated GP practice aligned to each care home. This improves communication and information sharing with care homes staff and consistency of care and case management through regular visits to the home.
The enhanced model also sees in-reach to care homes by integrated community nursing teams, independent advocacy and support provided for residents and care home staff having a better understanding of the services available as alternatives to ambulance call-out.
Dr Stephen Shortt, GP and Clinical Lead at Principia, said: “We are delighted to have taken part in the first evaluation from the Improvement Analytics Unit and are very encouraged by the results.”
“Older patients living in residential and nursing homes have the same right to quality NHS care as everyone else. We were determined to provide this equality by changing the way we delivered services and support. This has resulted in improvements in the continuity of care provided, standardised care planning in partnership with residents and their families, and a commitment to proactive management of health issues to reduce urgent and emergency call-outs.
“This has been a rewarding experience for all those involved in designing and delivering the new enhanced package of care. The report published today by the Health Foundation is further testimony to the hard work and energy of local GPs, community and voluntary sector teams, and care homes staff who have come together to make these positive changes.
“We have seen noticeable improvements in the way the health and wellbeing of care home residents is managed, and our local data and patient feedback also suggests our approach is working. We are looking forward to sharing our learning with other areas of the country as part of the New Care Models programme so that care home residents in other areas might also benefit from enhanced care.”
Adam Steventon, Director of Data Analytics at the Health Foundation and the report’s author, said:
“This is positive for the Rushcliffe residents and great news for Principia, as it indicates they have been successful in their aim to lower hospital admissions from care homes. Principia’s approach to improving care by developing good relationships between doctors, nurses and practitioners working across different organisations is one which has brought benefits to patients.
“The NHS is under enormous pressure currently, so it is more important than ever that services are given the opportunity to develop new ways of delivering care and can learn from those that are doing well.”