Developing and improving care pathways

Developing and improving care pathways

There’s always something new happening at Local Care Direct. Our team of experienced health professionals are constantly looking for ways to improve what we do and work with others to develop better pathways of care for patients.

Pioneering New Healthworker Role

We are working with Skills for Health (SfH) on their Role Redesign for Support Worker project.

This was a two year national project to work in partnership with 15 employers from across the health sector to redesign new and innovative roles for the support workforce, to promote new ways of working, enhance the quality of care and services provided, and generate productivity gains.

The project creates opportunities for support workers to work more innovatively across traditional boundaries and to help employers facilitate this flexibility by the development of new roles that are underpinned with quality assured standard role templates.

The LCD project has developed a national call handling job template which has been adopted across dementia support roles nationally and we are already using this new role in our own services.

Point of Care Testing

We’re working in partnership with Leeds Teaching Hospitals Trust A&E department and head of blood sciences to provide testing during the out of hours period.

Currently, patients who have blood routinely taken in their own GP surgery and the results become available after the surgery has closed, are asked to attend A&E for repeat tests to confirm abnormal blood results.

These patients more often than not already have a pre existing Long Term Condition. These do not necessarily require new interventions but part of a longer term monitoring from their own GP.

Currently, the receiving GP will be able to view the patient’s record and decide if this test will require repeating. The patient is contacted and asked to attend A&E for repeat potassium levels. This can often mean an ambulance journey and an A&E attendance.

Currently there is no facility to check patient’s abnormal bloods in the Out of Hours.

The initial test will be for repeat potassium that has been taken by patients own GP in hour’s primary care and the result becomes available in the Out of hours, after the surgery has closed.

This move to Point of Care testing is a huge leap in quality assurance as it makes the service much more reactive to patients needs and may prevent unnecessary patient attendance at A&E and subsequent admission.

 

Leeds Telehealth Pilot Extended

We are working in partnership with technology provider Alere Connected Health to monitor patients enrolled on the Leeds Telehealth Monitoring Service. The scheme involves the monitoring of the long term condition Chronic Obstructive Pulmonary Disease (COPD) and is monitored via question sets and vital sign data. The vital signs monitored were Blood Pressure (BP), Heart Rate (HR) and blood oxygen Saturations (SP02).

The problem we encountered was that previous models of telehealth care were not scaleable and sustainable because all the alerts triggered by the monitoring technology had to be dealt with by the front-line clinical teams. This was not an efficient or effective use of resources and prevented the scheme from fully realising one of the key patient outcomes from the use of telehealth technology – the prevention of unnecessary interventions including hospital admissions.

Our design and delivery of the service is built upon our extensive experience in the healthcare arena and a belief that Telehealth services are designed to support and be complementary to local health services and not to compete with them.

Our innovation was to implement a clinically-managed service which is technology agnostic (i.e. uses the right monitoring equipment for the patient rather than being dependent on one particular type of equipment or supplier).

The overall aim of our solution to the problem was to manage the increasing frontline workload and release capacity in the system for patients at greatest need for a face-to-face clinical assessment by those who know them best. It is empowering individuals with personalised support to gain greater control of their own health and delivering a proactive and sustainable health service, bringing care closer to home.

We are achieving this by detecting early signs of exacerbations, thereby allowing effective proactive evidence-based clinical interventions that allow patients to be treated closer to home.

The results and patient outcomes from the pilot are proving the concept.