A project involving an enhanced service package for care home residents has been linked with a reduction in hospital contacts, suggesting the model has potential for other parts of the country.
The partnership project significantly reduced both accident and emergency visits and admissions among older care home residents in Nottinghamshire, according to follow-up analysis.
“This report offers significant encouragement”
Care home residents in Rushcliffe Clinical Commissioning Group’s area received an “enhanced” care package delivered by Principia, an NHS multi-specialty community provider.
Principia is a local partnership of general practices and community services that was stablished as a community interest company in 2006, and serves a population of just under 125,000.
Its enhanced care package, introduced in April 2014, meant residents had regular visits from a named GP and independent support from Age UK Nottingham and Nottinghamshire.
Greater support for care home managers and nurses was also provided, for example, through a peer-to-peer network, training courses and signposting to existing specialist community services. Community nurses also accompanied GPs on the regular resident review rounds.
The residents attended A&E 29% less frequently than similar care home residents in other parts of the country, according to analysts.
“Principia has helped achieve better care for care home residents”
In a report on the project, the foundation said the positive results in Rushcliffe were likely to be the result of higher quality care being provided to care home residents by Principia, one of 50 so-called “vanguard” sites.
The vanguard sites form part of NHS England’s programme to develop and test new care models, as set out in its 2014 five-year plan the Five Year Forward View.
In conducting the evaluation, the unit arranged for data to be linked between multiple sources, creating a novel database of the hospital admissions of care home residents.
Researchers then compared the health outcomes of 588 residents in 23 care homes in and around Rushcliffe from 2014-16 with outcomes experienced by 588 controls living elsewhere in the country.
Apart from the enhanced care package, in all other respects the two groups were carefully matched by age, gender, ethnicity, socioeconomic deprivation, health conditions and type of care home.
Enhanced care home support ‘linked to fewer A&E visits’
The foundation’s report said that the positive results observed in the enhanced package group were “most likely” to be the result of the higher quality care they received.
However, before the approaches used are “replicated elsewhere”, the foundation said it was important to understand the causes of the lower observed use of emergency care.
The analysts acknowledged that it was currently unclear whether the enhanced care package itself or some other changes to care delivery were responsible for the good results.
Report author Adam Steventon, director of data analytics at the Health Foundation, said: “These results are good news for the Rushcliffe residents and good news for Principia.
“By enabling clinicians, care home staff and the charity sector to work together across organisational boundaries, Principia has helped achieve better care for care home residents, including fewer emergency hospital admissions,” he said.
Samantha Jones director for new care models at NHS England
Samantha Jones, director of the NHS New Care Models Programme and a nurse by background, said: “The team at Principia vanguard are working very hard to improve the care they deliver to local people, as well as to prevent ill health and save money.
“This report offers significant encouragement at a time when our NHS is witnessing increased demand for services,” she said.
She added: “We can see that the new models of care being tested and implemented by the 50 vanguards are making steady progress in reducing the pressure on GP and hospital services.
“These models are the foundations for transformation across health and care, including the sustainability and transformation plans (STPs),” said Ms Jones.
The Improvement Analytics Unit was set up in 2016 as a three-year partnership between NHS England and the Health Foundation to help improve the way care is delivered.
It provides data analysis into whether new ways of delivering care, for example, as part of national initiatives like the NHS new care models programme, are having a positive impact for patients.
Analyses produced by the unit are one of a range of complementary evaluation techniques being used by NHS England.