Care homes in Shropshire were able to reduce A&E attendances and hospital admissions by 10 per cent and improve trust between care home and health service staff due to the creation of nurse-led care home coordination centre (CHCC).
Developed by an Advanced Nurse Practitioner at North Staffordshire Combined Healthcare NHS Trust, the CHCC appointed a Band 7 advanced nurse practitioner (ANP) from older person’s mental health services with experience of working in care homes to lead the project. A team of nurses prioritised the homes with the highest hospital attendance and admittance to offer the following services:
- Provide a direct telephone referral route
- A daily supportive call
- Introduce a robust triage process
- Service publicity in care homes
- Collaborative working with the homes’ GPs
- Updated care home resource pack
- Skype for remote face to face consultations
- Co-ordinated GP visits to the care homes
- GP support for good end of life care
- Support from a care home pharmacist to initiate homely remedy policies and training for their residents
Quality Watch (2015) estimates that care home residents have 40-50 per cent more attendances at A&E and non-elective admissions to hospital than the general population aged 75 and over.