07 September 2017

Health and social care services in Tower Hamlets have established a number of new community teams to focus on supporting local residents who become unwell, to be looked after where they live. 

This will relieve pressure on A&E services, prevent long waits to be assessed in A&E, and avoid the need for a hospital admission. It also means that services are in place so that when someone admitted into hospital becomes medically stable, services are in place to enable the rest of their care to happen where they live. 

Admission, Avoidance and Discharge Service
This service has two components which focus on supporting people in their home and getting them back home from hospital as soon as possible.

The Rapid Response Team
The Rapid Response Team offers immediate intensive nursing care to support people in the acute phase of illness at home without the need for them to attend hospital at all. Their GP or the Ambulance service can refer straightaway and the Rapid Response team will carry out an assessment within two hours.

The Discharge to Assess Team 
The Discharge to Assess Team coordinate the discharge of people from hospital as soon as they are medically stable, assessing their health and care needs in their own home on the same day. 

Short-term Rehabilitation Provision
On rare occasions when an individual cannot be immediately supported where they live, but they don’t need to be in hospital either, they will be transferred to a short term community facility to continue their rehabilitation and recovery till arrangements are in place for them to return home.

New Older Person’s Clinic
The Older Person’s Clinic is a service which aims to help older people to stay healthy, mobile and independent. It aims to prevent ill health by catching problems at an early stage.  The Clinic offers a physical MOT, a review of medication, interventions and adaptations to people who show early signs of change or deterioration.

Reproviding Inpatient Rehabilitation
Research in other parts of the country show that carrying out continuing care assessments in people’s place of residence and instigating immediate care packages,  is more effective than carrying out such assessments in a hospital environment. 

We are noticing this trend in Tower Hamlets. Our inpatient rehabilitation facility, Jubilee Ward, at Mile End Hospital, has had a marked reduction in admissions - as the majority of people with long term conditions are remaining at home or going straight home from hospital. The findings are that in most cases, people do better going straight home than being transferred to another inpatient facility. 

So we are coming to the point where the ward is no longer needed and we want to transfer these staff to the community teams to work with people in their homes. We anticipate that the ward will no longer function as an inpatient service by October 2017 and that people will be treated and supported in the next stage of their recovery where they live.   

Q&As About Rehabilitation Services in Tower Hamlets 

Feedback
You can tell us what you think about these services by making a comment below, or give us feedback by emailing us at communications@elft.nhs.uk so that we can respond to you privately.

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Comments

  • Ambia Khatun , 22/09/2017

    That is fantastic news, hopefully the plan is implemented. Maybe other services based across the trust such as Luton can take this model into consider it, as it can speed up someone's recovery.


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