This Team work closely with our colleagues in social care to deliver a service which will support patients to remain at home with the right medical and social care support. By introducing the new roles and experiences in the team, the team now promotes hospital avoidance where possible and offers a 2 hour response for assessment. This ensures our patients receive the right care, in the right place, taking into account their specific needs, and we aim to stay in their home environment when appropriate and safe to do so. The Team work closely with Yorkshire Ambulance Service, G.P Practices, District Nurses, Palliative Care Teams and Gateway to Care. This approach is patient centred with the view to offer a one stop shop, for the patients of Calderdale, to receive medical and social care in the comfort of their own homes, and where appropriate avoid an unnecessary admission to hospital.
How has the nominee positively impacted you, the team, the organisation or the health service?
An individual is unwell, this Team is contacted as a 2 hour response. The Advanced Clinical Practitioner will conduct an assessment and prescribe what is needed, if they feel the patient is struggling socially they will refer to the Specialist Practitioner. An assessment will be completed and appropriate support from Senior rehabilitation staff (SRS) will be implemented. SRS will work with the patient around reablement, patient will be referred to reablement, who can continue with intervention for up to 6 weeks. If it becomes apparent that the patient has no rehab potential, they will be taken over by the Independent Living Officer (ILO) who will mirror what the SRS are doing however will then source an ongoing package of care. This ensures the patient has the right treatment for their needs at the right time, and a hospital admission has been avoided.
Additional Comments/Testimonials:
The team consists of Nurses, Therapists, Advanced Clinical Practitioners, Pharmacists, Independent Living Officers and Senior Rehabilitation staff. Since the live date in December 2021, Staff have all pulled together supporting each other with all the changes which at times have been challenging. Staff have accepted the evolvement of the team, staff have attended new training programmes and sessions to up skill themselves to be able to achieve the high standard that is expected of the team approach. They have participated in competency clinics to ensure they are up to date with fitting, demonstrating equipment, which is paramount in an individuals safety to be maintained in the home environment. The team are all proficient in medical observation training ,this ensures we monitor all our patients , medically, functionally, at all times, while also promoting reablement to maintain as much independence for the patient as is possible at that time.
CHuFT Awards 2025