Virgin Care has worked closely with NHS West Lancashire CCG since 2017, following a successful bid to deliver urgent care and adult community services in the district.
As the existing provider, we were approached to scope and implement an assistive technology service to support patients in accessing telecare, within 24 hours of referral, during the COVID-19 pandemic. This would target more than 4,000 people in the shielded group as well as responding to referrals from community and primary care and some hospital discharges.
The existing, council-commissioned assistive technology service in the district required a referral to be made into adult social care and a Care Act assessment carried out. Increasing referrals through this already-stretched route would slow down provision and create waiting lists. We were challenged to create an expanded service to run alongside the current pathway, reach a wider group of people not eligible to be referred through the existing route, and provide a simple referral route.
The purpose of the service would be to:
• Support the shielded group to remain safe at home
• Facilitate safe hospital discharges
• Increase independence and confidence
• Keep carers safe
• Reduce admission or readmissions to hospital
• Reduce unnecessary contacts with high risk groups
We initiated discussions with a number of providers and made a recommendation that the CCG use the Progress Lifeline service, which offers an extensive range of discreet wireless sensors that can be worn or placed in a patient’s home to detect situations that may be unsafe. The sensors call for help without the patient having to do anything.
Progress also offers an assistive lifting service that is triggered if a patient falls, is uninjured, and does not need medical attention. The average time for responders to arrive on site is just 27 minutes. This is a reputable service commissioned by the integrated care system, Lancashire County Council and multiple clinical commissioning groups in the region.
There were more than 4,000 people identified in the shielded group, who could be targeted via social prescribers reaching around 20 clients per day and prioritising the most vulnerable. We knew that 45 per cent of hospital discharges would need some support, though some of these would be picked up under social care, so modelled an expectation of around five referrals a day; and in addition we planned for around five to 10 referrals per day from community and primary care.
Leaflets were created for each of the key patient cohorts to be mailed out with the referral letter. The leaflets highlighted the benefits of the service, used simple language and gave a clear call to action so patients knew what to do next, and outlined some of the choices available but gave examples of the most common to avoid ‘overload’. A practitioner leaflet was also created to simplify the process for staff referring to the service using four easy steps: Get to know the person’s needs, identify a helpful device, highlight the benefits and take action.
A web page is available for practitioners to make referrals at https://www.progresslifeline.org.uk/wlreferral.
West Lancashire now has a simple, effective process in place to allow practitioners to refer to and patients to access telecare support from a reputable provider. They can now access this support within 24 hours.
We are now working with the CCG to scope potential telemonitoring solutions to support care home residents and patients in the community with long term conditions.
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