Interventions Phase I

Four virtual beds and a roving night team providing home visits and overnight support in patients’ own homes. The service complements existing Community Health Services unscheduled care and social care crisis response services to provide 24-hour unscheduled care. It incorporates nursing assessment and therapeutic intervention, including the identification and management of low-level social care needs to ensure patients are safe at home. The service is available seven nights a week from 10pm to 8am and is a fully integrated part of community health services so that the needs of patients are met over 24 hours. It operates across Leicestershire County and Rutland and is available to patients registered with a Leicestershire County or Rutland GP.

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SIMTEGR8 User Handbook - Integrated Crisis Response Service

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Read the Night Nursing Project Leads Report

Read the Night Nursing Service Users Report

2. Older Persons Unit (OPU)

A geriatric specialist outpatient clinic situated in Loughborough for a comprehensive assessment of individuals that are referred by their GPs. The OPU provides GP’s and other health care professionals such as ambulance and ED staff with an alternative method of obtaining a comprehensive geriatric assessment as opposed to admission to hospital. Nursing homes can also make direct referrals to the OPU. The service offers clinical assessment and support which is initially provided by an Advanced Nurse Practitioner specialising in older people and a Consultant Geriatrician. At the unit, the patient receives a comprehensive geriatric assessment including diagnostic testing such as bloods and x-rays.

The service is available Monday to Friday – 9am-5pm (excluding bank holidays)

Read OPU Project Leads Report

Read OPU Service Users Report

The approach has two distinct but interdependent work streams; a comprehensive Prevention strategy and the Emergency response (East Midlands Ambulance and community support). The latter comprises a comprehensive hospital non-conveyance pathway whereby potential admissions are assessed by paramedics using a falls risk assessment tool and referred onwards to an appropriate community based service if conveyance to hospital is not required.

During 2015 both CCGs to tested an initial phase of pilots of seven day working, with the aim of developing a local and sustainable approach to seven day working for primary care and specifically to meet the needs of older and vulnerable patients with effect from 2016/17 onwards. A review of the first phase of the pilots has been undertaken and the findings have informed revised specifications.