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Pioneering acute trust hails ‘successful’ first year of domiciliary care in Devon

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An hospital trust, which was the first in the NHS to enter the home care market, says the first year of its new service has exceeded its expectations.

As previously reported by Nursing Times, Northern Devon Healthcare NHS Trust launched Devon Cares last year. The acute trust uses it to manage domiciliary care providers in three areas of the county, but does not directly deliver the services itself.

“We had a week of practice before the contract went live”

Andy Ibbs

In an interview, Andy Ibbs, the trust’s director of operations and strategy, said the first year has been “successful” and “gone better than we hoped”.

Northern Devon was awarded the five-year contract, worth between £70m and £80m, in April 2016 and then embarked on three months of “hectic” preparation.

“We had to procure an IT system; we had to get all the providers onto our books; and we had a week of practice before the contract went live,” he told Health Service Journal.

But the number of “unfilled” packages of care – relating to patients who have not yet had a caseworker assigned to them – was brought down from 28 to zero on occasions during its first week.

Mr Ibbs said there were, on average, 20-25 unfilled packages of care at any given time in the year before the trust won the contract.

Devon Cares now reports that the number of unfilled care packages at any one time is usually less than five. In addition, 70% of packages are filled within 1.5 hours of referral, and 97% within four.

The service receives around 30 new care packages that need to be filled every week from Devon County Council.

The trust initially worked with 23 providers, ranging from national companies to small village organisations, but this has expanded to 31 providers over the past year.

Northern Devon Healthcare NHS Trust

NHS trust pioneers new home care service

Andy Ibbs

Mr Ibbs said the care providers have reported better staff retention rates, which he attributed to improved career opportunities and more flexible working due to closer links with the trust.

NHS England figures show a small reduction in delayed transfers of care from the trust between 2015-16 and 2016-17, but Mr Ibbs said those caused by waits for care packages had “fallen sharply”.

He said the next priorities for Devon Cares included fully integrating a shared managing system and developing a system where domiciliary care workers could look after patients in their homes while their care plan was designed – rather than the patient waiting in hospital for a discharge plan.

The trust was also in early stages of discussions with the council over a potential shift to an outcome-based contract to encourage providers to increase their focus on supporting patients to become independent and not rely on care, he added.

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