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Case study: Supporting care homes to join NHSmail

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Bringing together partners with transformation experts and Londoners is one of the key roles Healthy London Partnership (HLP) plays in tackling London’s most complex health challenges. Through partnerships with NHS Digital and NHS England, Healthy London Partnership has played a significant role in bringing a group of care homes onto NHSmail. What was the challenge? Care homes largely rely […]

Social prescribing: our vision for London 2018-2028

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Over the last few months, the Healthy London Partnership (HLP) proactive care team has been working closely with the Greater London Authority (GLA) and other key stakeholders to develop a ‘Social Prescribing Vision for London’. The vision has been developed by the GLA, NHS England, HLP and the London Social Prescribing Network, in collaboration with […]

Case study: Developing pan London commissioning policies

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Bringing together partners with clinicians and Londoners is one of the key roles Healthy London Partnership plays in tackling London’s most complex health challenges. Through clinically-led partnership working across London’s Sustainability and Transformation partnerships (STPs) and NHS England (London region), Healthy London Partnership has played an important part in the development of pan London commissioning […]

Case study: Lewisham GP Extended Access (GPEA) Service

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London has been leading the way to ensure everyone has easier and more convenient access to GP services, including appointments at evening and weekends.  It was the first region in the UK to fully offer extended access services to the entirety of its 9 million population. An example of practices working collaboratively at scale to provide GP extended access […]

Case study: NHS e-Referral Service rollout for London

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Bringing together partners with transformation experts and Londoners is one of the key roles Healthy London Partnership plays in tackling London’s most complex health challenges. For example, through recent partnership working between local organisations, NHS England (London region) and NHS Digital, Healthy London Partnership has played an important part in helping London switch off paper […]

Case study: London’s mental health handover form

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Some of the things we do might be small and simple but have a massive impact on people’s lives. For example, we worked with London’s A&E departments and police forces to develop a handover form, which has resulted in 83 per cent fewer people going missing from A&E when having a mental health crisis, compared […]

GP extended access services: communications toolkit

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Materials to support a public marketing campaign about extended access services in London.  The marketing mix will include digital, radio and print advertising across London and is part of the Stay Well This Winter campaign. There are many ways practices can make sure their patients know about and use extended access services. It is important that […]

Hospital at home: Whittington

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Started: 2014 Region: Islington CCG, North Central London Geography: Urban Estimated local pop. 0-18 years: 40,500 Background 8 months of planning prior to opening service Commissioners of local CCG involved from start of planning phase Aims To reduce LoS of admissions to Whittington Hospital Target patient groups Acutely unwell CYP (respiratory is the main referral) […]

Acute care pathways

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West Sussex children and young people care network acute care pathways Started: October 2013 Region: North West England – Cheshire & Merseyside Geography: Urban Estimated local pop. 0-18 years: 48,800 Background Warrington consistently has non-elective admission rates which are higher than the national average. Warrington has a higher expenditure on trauma and injury admissions compared with […]

Hospital at home: Walsall

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Walsall Paediatric Hospital at Home Service, ‘Building Better Health’  Started: 2008 Region: Walsall Geography: Urban Background Reconfiguration of local hospital services, with need to reduce in-hospital paediatric beds from 36 to 21 prior to the move Aims Reduce the need for in-hospital paediatric beds Eliminate unnecessary admissions to hospital if care can be provided at […]

Integrated community virtual ward

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The Bridge: An integrated community virtual ward for children with complex needs  Started: 2014 Region: Tower Hamlets, North East London Geography: Urban Estimated local pop. 0-18 years: 90,000 Background The Bridge began as a pilot project at Barts Health NHS Trust under the Darzi Fellowship scheme and ran from March 2014 until July 2014. It was […]

Senior telephone advice

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Nottingham Children’s Hospital senior telephone advice Started: Formally in September 2015, Pilots and partial implementation from 2012/2013 Region: East Midlands – Nottingham City and South Nottinghamshire Geography: Mixed Estimated local pop. 0-18 years: Nottingham City 59,000, South Nottinghamshire 102,000 Background A project team working on improving the pathway for emergency medical admissions identified that when […]

Reducing avoidable admissions

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Taunton: Reducing avoidable admissions Region: Plymouth Geography: Rural Background 20% year on year increases in referral rate To improve integration with primary care Target patient groups 0-18 year The service model Reducing avoidable admissions centred around three main strategies: 1. Putting expertise at front end of pathway e.g. senior on admission phone, consultants on shop […]

Seven-day community children’s nurse

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South Tyneside Community Children’s Nursing Team, seven-day community children’s nurse Started: 1998 Region: South Shields, Jarrow, Hebburn, Cleadon and Whitburn Geography: Coastal region mainly urban Estimated local pop. 0-18 years: 0 -15 population is 26,385 Background Service is to provide nursing care, education, support and liaison for population of South Tyneside. The aim is to […]

South Staffordshire Service

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The South Staffordshire Service Region: South Staffordshire, Burton, East Staffordshire, including Uttoxeter. Also just across the County border, if registered with GP practices in South Derbyshire. Geography: Urban and rural Background / Motivation GPs who wanted to reduce hospital admissions Aims Hospital avoidance Care close to home Early hospital discharge Target patient groups Referrals are […]

Children’s walk-in centre

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Smithdown Children’s Walk-in Centre, Liverpool Community Health NHS Trust  Started: 2005 Region: Liverpool Merseyside Geography: Urban Background Developed through a redesign of the Minor Injuries Unit that had been built due to the impact of the closure of Myrtle street Children’s hospital and the need for a service near to an area of high deprivation. […]

Community partnership

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Salford Children’s Community Partnership Started: Phase I (proof of concept):  April 2011 – June 2014; Phase II (proof of scale):  July 2014- June 2016 Region: Little Hulton (Greater Manchester) Geography: Urban Estimated local pop. 0-18 years: Little Hulton total population (2011 Census) = 12,851 Background / Motivation The project was designed as a community-based alternative […]

Rapid access clinic

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Rotherham’s urgent referrals clinic for children under 16 years of age Started: 1995 Region: Rotherham Geography: Urban Estimated local pop. 0-18 years: 62,000 Background To provide an immediate consultant appointment for GP and emergency department referrals for children <16 years (who are not acute emergencies but can’t wait for a routine outpatient appointment). Aims To […]

Rapid response team

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Luton Children’s Rapid Response Team phase 2   Started: Jan 2014 (phase 1 started in April 2013) Region: Luton Geography: Urban Estimated local pop. 0-18 years: 60,000  Background / Motivation A review of paediatric acute activity in 2008/9 identified that there were 6 high volume common conditions accounting for 85% of all children’s emergency activity. Aims Developed as a sustainable model of integrated working […]

Rapid referral clinic

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Cambridge out patient department management to reduce emergency admissions  Started: 2006 Region: Cambridge Geography: Urban  Background / Motivation Admission avoidance ( referred patients) Less than two week wait access to a senior paediatric opinion for primary care professionals One stop clinic: Detailed written management plans enhancing primary care knowledge of management Aims Rapid access to senior staff, avoidance of admissions to hospital where […]

Partners in paediatrics

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Started: 2010 Region: West Midlands Geography: Mixed  Background / Motivation The hospital identified that the number of children with acute health problems admitted to paediatric wards was about twice the admission rate of other hospitals in similar communities. There were 10  common conditions where children referred into the hospital by a GP were discharged within four hours without active clinical intervention Aims […]

Paediatric acute response team

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Paediatric Acute Response Team (PART), Bath Street Clinic, Warrington Started: October 2013 Region: North West England – Cheshire & Merseyside Geography: Urban Estimated local pop. 0-18 years: 48,800 Background Warrington consistently has non-elective admission rates which are higher than the national average. Warrington has a higher expenditure on trauma and injury admissions compared with comparator […]

Paediatric unscheduled care

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Paediatric Unscheduled Care (PUC) pilot, North of Scotland Planning Group Region: Rural areas of Scotland (25% of children in Scotland live in remote and rural settings) Geography: Rural Background / Motivation To provide safe, sustainable paediatric care to rural areas of Scotland The service model On-call paediatric consultant model, providing 14 rural general and community […]

Manchester community children’s service

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Region: Covers City wide Manchester Geography: Urban Estimated local pop. 0-18 years: 120,000  Aims Deliver nursing care closer to home for children and young people who are acutely ill, have long term conditions or who have complex health needs. Reduce avoidable hospital admissions of acutely ill children and young people. Facilitate early discharge from hospital after elective and non-elective admissions. To improve access to health […]

Lewisham and Greenwich: hospital at home

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Lewisham and Greenwich Children’s Community Nursing Team and Hospital at Home Team   Region: Lewisham, Lambeth and Southwark Geography: Urban  Aims To promote independence for families and facilitate earlier discharge from hospital, fewer re-admissions and reduce the number of hospital visits for the family. Enabling children to return to their home environment and be supported there whilst continuing with their usual lives […]

Kingston Paediatric Outreach Nursing Team

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Kingston Paediatric Outreach Nursing Team (PONT)  Region: Kingston Geography: Urban Estimated local pop. 0-18 years: 37,000  Background Commissioned service by Kingston CCG to provide paediatric community service to all children and young people age 0-18 years registered with a Kingston GP. Aims To provide quality nursing care to children and their families. To reduce the need for ED attendance/hospital admission/ reviews in ambulatory […]

King’s paediatric ambulatory service

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Paediatric ambulatory service, King’s College Hospital Staged over several years: Rapid access clinic – 2009, Paediatric phone line – a 2014, Healthcare at Home – 2014, Short Stay Unit (SSU) – 2014 Region: London Geography: Urban Background / Motivation To deliver high quality healthcare for children, streamlining their patient journey and thereby optimise their patient […]

Integrated paediatric services

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Sandwell and West Birmingham Hospitals NHS Trust integrated paediatric services – Community Children’s Nursing & Therapies Service Started: Integrated with Community children’s therapies in 2014  Region: Sandwell, West Midlands Geography: Urban Estimated local pop. 0-18 years: 76,867 Background Integrated CCN services across acute wards and in the community. This service was set up for those […]

Gloucester Big 6

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Background / Motivation There had been an increase in paediatric emergency admissions to the local Foundation Trust (FT) of 15% over the previous 3 years. Benchmarking data suggested that the rate of admissions for respiratory infections, bronchiolitis and gastroenteritis for under 2s were higher than other comparable demographic areas and Gloucester consistently has the highest […]

Evelina Children’s Hospital

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Children and young people’s health partnership (CYPHP), Evelina Children’s Hospital Started: Programme in Autumn 2016, Model live in January 2017 Region: Lambeth and Southwark Geography: Urban Estimated local pop. 0-18 years: 120,000 Background To develop and test a new model of comprehensively integrated care, as part of a strengthened child-centred health system. Aims To improve […]

Connecting for care for children

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Connecting for care for children (CC4C) Started: 2012 Region: North West London – urban; including populations of significant social deprivation Geography: Urban Estimated local pop. 0-18 years: 400,000 (eight CCGs).   Aims To develop a collaborative integrated child health system, placing general practice at its heart and reinforcing the role of the GP Target patient groups CC4C is a ‘Whole Population’ model of care, […]

Child healthcare closer to home

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Child Healthcare Closer to Home (C3), Calderdale and Huddersfield NHS Foundation Trust Started: May 2014 Region: Calderdale and Greater Huddersfield and who are registered at one of the listed pilot practices.  Background / Motivation The journey of the child through acute care can be fragmented, with the focus being around a specific professional and building rather than the family. Partners […]

Children’s acute nursing initiative

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Children’s Acute Nursing Initiative (CANI), CCN Service, Children’s Directorate of Newcastle Hospital NHS Foundation Trust Started: 2008 Region: Newcastle Upon Tyne Geography: Urban Estimated local pop. 0-18 years: 64,100   Background / Motivation Prevent breaches in ED by freeing up beds in children’s services Free up beds in winter pressures and therapeutic community care for children with acute episodes of illness. Initial pilot with […]

CRAFT (rapid assessment)

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Children’s rapid assessment and follow up team (CRAFT), Leicester Children’s Rapid Assessment and Follow up Team   Background / Motivation Avoid children and young people being admitted to hospital wherever possible and safe to do so. The service model Provided: Clinical assessment and observations in their own home Clinical reviews Education and support for the children and young […]

COAST

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Children’s Outreach Assessment and Support Team (COAST), Solent NHS Trust Started: 2008 Region: South East Geography: Portsmouth and Southampton Background Facilitate early discharge from hospital Reduce unnecessary attendances and admissions to hospital Aims Providing a safe service which can assess and monitor a child during an acute episode of illness in their own homes, whilst also […]

Bromley by Bow: DIY Health

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A co-produced health education delivery model to empower parents in managing children’s health Region: Bromley Geography: Urban Background motivation It was noted that parents of children under the age of 5 were frequently re-attending St Andrew’s Health Centre (one of three surgeries run by BBBHP) for support with managing self-limiting childhood problems. These group learning […]

Acute Community Worcestershire

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Worcestershire Acute Hospitals – Acute Community Children’s Nursing Team – Orchard Service (provided By Worcestershire Health and Care Trust) Started: 1996 Region: South Worcester & Wyre Forest and Redditch & Bromsgrove Geography: Areas of urbanisation but with large rural areas Background Initially acute service promoting early discharge preventing admission. Additional funding over a number of […]

Overview

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Find out how other organisations have developed place-based models of care for treating acutely unwell children and young people in the most appropriate location for their needs. These are case studies of services developed for acutely unwell children and young people that are provided at places that are not hospitals. The report is for commissioners and […]

Acutely unwell children and young people: compendium of new care models

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Case studies for commissioners and providers of out of hospital healthcare services for children. Different services are described to help others understand what some areas are already doing. We collected information directly from services and have not conducted independent evaluations. Details are included where a service has carried out an evaluation. A local contact you can approach for more information has been identified […]

Further information

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EHCH Framework: NHS England’s Enhanced Health in Care Homes Framework document Acknowledgements Case Studies: CarePulse case study Significant 7 training Haringey – case study 2018 Significant 7 training Barnet – case study 2018 CarePulse use across Havering – case study   Examples of best practise: Embracing risk; enabling choice to support patients return home first […]

Enhanced health in care homes

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On this page you’ll find resources and information to support care homes and healthcare commissioners to improve the quality of health in care homes and patient flows across London. Enabling people to live at home as long as possible is a key ambition for health and social care. It is also important that when people […]