West Suffolk NHS Foundation Trust - case study

older woman and care worker

28 / 01 / 2016

In West Suffolk, efforts to prevent unnecessary emergency admissions to hospital do not just take place in the A&E department. The Early Intervention Team also works in the community, reaching out to support patients who may be at risk of admission. Often the team supports frail elderly or clients with long term conditions.

The team crosses health and social care providers, as well as the voluntary sector. The team consists of: community nurses, a dementia liaison nurse, social workers, occupational therapists, physiotherapists, rehabilitation assistant practitioners, reablement support workers (carers) as well as support workers from Age UK Suffolk and a carer link worker from Suffolk Family Carers. Together, they provide a “one stop shop” to help people retain their independence and avoid hospital admission when it is unnecessary.

In addition to working in A&E and the community, members of the team are also present on the acute medical unit. Here they help ensure support is in place to allow patients to leave hospital as soon as they are medically fit to do so. This often includes assistance from the voluntary sector members of the team. Age UK Suffolk, for instance, can provide transport to take people home from hospital, as well as continuing help from the charity following discharge – including assistance with housework, shopping and financial advice.

This cross-disciplinary and cross-boundaries approach helps ensure our patients have the support they need, when they need it, to help manage a crisis.

For more information:

Gareth Blissett, Team Lead Early Intervention Team, West Suffolk NHS Foundation Trust

gareth.blissett@wsh.nhs.uk

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