The North West London Collaboration of Clinical Commissioning Groups (CCGS) saw an opportunity to reduce Accident and Emergency (A&E) attendances and admissions and increase patient referrals by 60%.
The problem
As A&E admissions and attendances have been increasing over the past years, the NHS has been struggling to cope with rising pressures.
The solution
We reduced avoidable A&E attendances and admissions by increasing referrals from London Ambulance Service (LAS) to Rapid Response Teams (RRTs).
RRTs can assess patients within two hours of receiving a telephone referral and provide short-term treatment in their own home.
LAS crews participated in education and engagement events, which cover the range of services offered by rapid response services, identification and selection of patients and ways to make an effective referral.
An awareness campaign was launched to remind ambulance staff what they can do to prevent a hospital admission.
RRTs include nurses, occupational therapists, physiotherapists and health care assistants who have access to medical and social care input.
Depending on patients’ clinical need, RTTs will visit patients in their own home several times over the course of a week, involving their GP in their care.
The challenges
Rapid response services have been available for several years. However, across North West London, there are eight services running with five different service providers.
The challenge was to ensure LAS crews had the right information. Once we understood that, it was easy to utilise all rapid response services across North West London.
The results
In the six months prior to this work, an average of 95 patients were referred by LAS each month.
As a result of coordinated education and engagement across services, this has increased to 140.
In October and November 2017, 279 referrals were received compared with 195 in the previous two months. This means more patients have avoided unnecessary trips to A&E and possible admission.
Overall, there has been an increase of over 60% in referrals in November 2017, compared to 2016.
The future
The use of iPads has made it easier for crews to access contact and referral criteria information while they are with a patient.
Rapid response services and LAS will continue to work together to reduce avoidable hospital admissions.
CCG comment
Katherine Murray, Head of Community Independence Service (CIS), Central and North West London NHS Foundation Trust (CNWL), said: ‘A&E isn’t always the right place to provide care, especially for some of our elderly patients, as being taken into a busy and unfamiliar environment can be distressing.
‘Where clinically possible, it is much better for people to be treated and cared for in their own home.’
NHS North West London Collaborative of Clinical Commissioning Groups are a collaboration of NHS Brent CCG, NHS Central London CCG, NHS Ealing CCG, NHS Hammersmith & Fulham CCG, NHS Harrow CCG, NHS Hillingdon CCG, NHS Hounslow CCG, and NHS West London CCG
