Service changes in the community to help reduce hospital admissions

The CCG has opened the Integrated Acute Frailty Virtual Ward Round. Picture: CCG

The CCG has opened the Integrated Acute Frailty Virtual Ward Round. Picture: CCG - Credit: Archant

A service has been introduced in North Somerset to enable frail people to be supported in the comfort of their own homes.

In response to challenges posed by coronavirus, clinicians and key workers have come together to implement the Integrated Acute Frailty Virtual Ward Round.

The multi-agency initiative gives the opportunity on any weekday for GPs to refer frail individuals to a team of experts who will be able to assess their care needs away from hospital on the same day.

Clinicians will provide a care plan for each person to support GPs or community teams to care for the individual in their own home, and in so doing improving patient care and reducing the need for people to be admitted to hospital.

The service has been operating since June, and supported 13 people in its first week in operation.

Dr Martin Jones, medical director for Bristol, North Somerset & South Gloucestershire CCG, said: “This is a really positive initiative for an area that contains a high number of care homes and frail people, enabling them to continue to be cared for in their home environment where they have better long-term outcomes.

“We know that we cannot avoid all hospital admissions.

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“However, through the virtual ward round we can enable a planned approach of care, where people will have a shortened length of stay and clear pathway out of hospital when medically well.”

Dr Holly Paris, GP for Pier Health Group, added: “For the GP or community clinician utilising this service, being part of the Virtual Ward Round is a real privilege.

“It offers advice and guidance that’s not only extremely responsive, but invites you as a practitioner to be part of that multidisciplinary discussion and decision making.

“A key part of the virtual ward round is the involvement of social care, as so much of a person’s management plan hinges on their circumstances and this knowledge is not otherwise readily available.

“For me, I’ve also learned most from the approach of my mental health colleagues in managing dementia crises which has an impact on my day to day practice. It’s such a rich learning environment.”