Keeping people out of hospital is essential for the sustainability of the NHS, but it is also important for our patients, enabling them to make a speedier recovery if they are given the right support closer to home.
We have been working with our GPs and providers to improve what we do to keep people out of hospital when they don't need to be there. Below is some of the work we have done:
Acute Medical Clinic
This was originally developed at University Hospitals Birmingham NHS Foundation Trust (UHB) and has now been introduced at Heart of England NHS Foundation Trust (HEFT). It involves a further assessment of patients who have been seen in A&E and who, under the previous system, would probably have been admitted for a short stay in hospital.
Patients are triaged into the consultant led clinic, which has excellent access to diagnostic tests. The results of this additional expert review and assessment are very encouraging, with approximately 80-85% of patients being able to return home that day with a diagnosis and a treatment plan, rather than being admitted to hospital.
Discharge to Assess
We received national funds to help improve the urgent care system. One of the schemes we developed with this money is called Discharge to Assess, which provides beds where people can be more effectively assessed, ensuring a better flow of patients from hospital to somewhere more suitable.
This allows patients to continue to receive the right kind of care outside of hospital until they have been assessed for appropriate long term care. Between December 2013 and March 2014, around
200 patients benefited from this new initiative.
Redesign urgent care
Urgent care is one of our three priorities for 2014-16 and we have been looking, in collaboration with other CCGs, at how urgent care is provided in Birmingham and how it can be redesigned to provide a much better service for Birmingham people.
The main aim of this is to provide for unplanned treatment for people in settings other than A&E and to ensure there is support to help people stay out of hospital. Read more about urgent care.
Community Medical Assessment Unit (CMAU)
Located at Moseley Hall Hospital, the CMAU operates Monday to Friday, from 8am to 8pm, and is intended to provide better care for patients aged over 65, closer to their home, maintaining independence and avoiding unnecessary hospital admissions.
The CMAU supports the on-going development of a "whole system" integrated approach to a number of services to enable patients to remain in the community and close to home, rather than being admitted to acute medical beds.
The unit will be integrated into the current community service model, providing a community alternative to an acute hospital admission.