For a new service to achieve a 100% satisfaction rating from service users and their families is quite an achievement. It is even more impressive when the service is so new that it is still being piloted.
Yet this is what has happened to a prevention and avoidance community team (PACT) project that has been running in Lincolnshire. Its success has been such that the decision to make it permanent was taken before the pilot ended.
PACT is about getting those over the age of 60 back home from Lincoln County Hospital as quickly as is safely possible. For most of the 100 people helped in the pilot so far, it means that a visit to A&E results in a return home instead of admission onto a ward. Some have been admitted but social needs, rather than medical, mean that their discharge would otherwise have been delayed.
Trixie Bennett, chief executive of Adults Supporting Adults, which is one of the care providers behind PACT, gives the example of someone with a urinary tract infection who has been given the medication and fluid needed.
“Sometimes that person is then admitted to be monitored, but that can lead to disorientation and upset because of the hospital surroundings. We take them home where it is familiar. We’ll provide the transport, put the heating on, put food in the cupboards and organise a telecare system if they don’t have one already,” she says.
If there is a social care need, PACT meets it.
“We provide a continuum of service. And if the family can’t respond immediately, we can stay with the person for a few hours to make sure they have a meal and company,” Trixie says.
Even better, the service is able to respond quickly; members of PACT have set themselves a two-hour response deadline. To date, they have met the deadline on every occasion.
As well as the speedy response, Trixie says clients report that they particularly like that they are supported by more than one staff member. At least two PACT workers accompany an individual home.
“Our clients enjoy two to three people taking them home and getting them settled. They feel very secure with that arrangement,” says Trixie.
PACT comprises about 30 individuals who work 12-hour shifts, 10am to 10pm. At any one time, there are four PACT workers in the office and six more on standby at home.
As well as the obvious benefit to the individual, who is settled back home instead of being stuck unnecessarily in hospital, the PACT service avoids costly bed-blocking. Although the independent evaluation of PACT has yet to be carried out, which will involve looking at the cost savings in Lincolnshire, the amounts involved are likely to be significant. Last year, a NHS Confederation report Papering over the Cracks: the impact of social care funding on the NHS said that bed-blocking costs the NHS £545,000 a day – approximately £200m a year.
PACT is the first project from a Lincolnshire consortium comprising four care providers – Adults Supporting Adults, Age UK Lincoln, The Home Improvement Agency and Lace Housing Association. The four providers recognised that their shared principles and expertise meant they could work well together.
The aim of the consortium is to help each other cut through the bureaucracy that providers face with local authorities and the NHS while also simplifying the process for clients seeking to find a service.
In the meantime, their first project has shown such success that that, as well as being made permanent, there are plans to roll out the service to include other hospitals and areas of the county.
“We’ve heard one or two stories from clients who have been to A&E in the past and felt that the process of being dealt with was very lengthy and sometimes detrimental to their wellbeing. This is completely different – it avoids admission, prevents bed-blocking and it is good for the individual,” says Trixie.
Julie Griffiths
quotes:
“PACT is about getting those over the age of 60 back home from Lincoln County Hospital as quickly as is safely possible.”
“Our clients enjoy two to three people taking them home and getting them settled.”
