Safely Reducing Avoidable Conveyance Programme

Doncaster Single Point of Access and Rapid Response Team

Brief Description of Initiative

YAS pathways to a single point of access (SPA) in Doncaster area, which includes referrals to respiratory nurses, community nurses, therapists, social support and recovery, geriatricians and MH liaison. A rapid response team (who respond within 2 hours) also sit within the SPA.

Date Initiative was introduced in Trust

December 2017.

Date of upload or review

Uploaded to Repository 1st January 2020.

Background Context

Following on from the implementation of pathways to singular services within Doncaster, a single point of access was developed by the local providers and CCG, which allows access to YAS clinicians, GP’s and other community based clinicians. The Doncaster SPA was set up to advise on and coordinate a multi-agency response through direct clinical conversation and handover with a HCP.

Which specific patient group or presenting need is this response targeted at?

Patients at risk of hospital admission due to poor mobility, post fall, respiratory condition or social need. Management of minor illness/injury (housebound), community nursing and therapy needs, social care and end of life care; frailty.

Geographical area or location covered by this response model

Doncaster Area only

Key Aims
  • Promote shared decision making between services and clinicians
  • Enable community teams to manage caseloads effectively through prioritising referrals
  • Coordinate a multi-agency response and reduce avoidable conveyance to ED
Benefits for Patients
  • Care provided closer to home and in the community
  • Care and treatment provided by community teams with access to patient care plans and records
  • Holistic approach to treatment and care
Benefits for Trust or System
  • MDT approach to providing care to patients
  • Reduce attendance at ED and therefore reduce hospital burden
  • Provide care in the community in line with NHS direction and strategy
Implementation

1.     How long has this initiative been operational?

2 years.

2.     Days / Hours of operation:

Single Point of Access is 24/7. Access to the rapid response team is 0800-2000, 7/7

3.     Which clinicians are involved in the response and how many WTEs (if a specific cohort)?

Normal staffing. No additions

4.     Which other partners are involved in providing the response?

Rotherham, Doncaster and South Humber NHS Foundation Trust (RDaSH)

5.     What other key resources are needed for this response to work? (vehicles, specific equipment etc)

N/a

6.     How is the initiative funded? (level of engagement/support from CCGs etc)

CCG commissioned service

7.     What were the main facilitators / blockers / interdependencies when introducing this response?

Facilitators – YAS clinicians engagement and knowledge of the service and provision.

Evaluation & Monitoring

1.     What are the key success measures?

  • Reduction in readmission rates
  • Length of stay
  • Improving patient experience

2.     How are these being measured / collated / monitored? (frequency / who reported to etc)

Collated by RDaSH. July 2019 referral information below:

3.     Has a formal evaluation process been undertaken (independent / inhouse)?

N/A.

4.     What are the current findings in terms of the success measures?

Numbers of referrals from YAS remain steady but low. Work to do to increase confidence of crews in using this pathways and supporting reducing avoidable conveyance

Sustainability

1.     Does the trust intend to continue with this response for the foreseeable future

Commissioned service. YAS pathway is reviewed annually but will continue

2.     What long-term resourcing requirements are there?

None for YAS

3.     What risks have been identified (for patients / trust / system) in providing this service and how have these been mitigated?

No risks identified. Patients assessed quicker in the correct place. No reported incidents since the inception of the pathways. Acute Trust site has an A&E department should that be required but no reports of this being utilised by patients YAS have transferred directly to the frailty ward.

4.     Is there potential to expand this response model?

SPA’s exist in different areas of the Trust now, which work similarly to the Doncaster Model

Sharing & Learning

1.     What has the trust learnt most from introducing this process?

The importance and benefits of a SPA to coordinate care for each patient and support crews in navigating an often complex system.

Investing focussed time engaging with and communicating with frontline crews has improved knowledge of and access to this unit.

2.     What might be done differently with the benefit of hindsight if implementing again? (in another part of the trust for example)

Additional Information

Doncaster Intermediate Care Evaluation Framework – Rapid Response Service as at 30th August 2019 – PDF

Doncaster SPA

ScHARR Evaluation

This Initiative has been the subject of an evaluation review by ScHarr – read the report here.

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