This week, BBC Radio 4 Today and BBC TV Points West have been in Somerset exploring how NHS Somerset and Somerset County Council is responding to the unprecedented demand on our health and care services, by coming up with innovative solutions to help ensure we can provide health and care where, when and how it is most needed.
We know in Somerset, there is an increasing demand for our services and our staff have never been under such pressure. And increased pressures are now not just being seen in the winter but all the year around.
By developing new initiatives such as reablement beds in the community, Ready to Go Units in hospital and the Hospital@Home service, we hope to help ease the pressures in hospitals by caring for people in the right place at the right time, helping to improve bed availability for people who need to be cared for in hospital and patient flow. This includes either preventing avoidable admissions into hospital or supporting early discharge out of hospital.
How we’re helping to ease pressures
Reablement Centres
By developing new initiatives such as reablement beds in the community, Ready to Go Units in hospital and the Hospital@Home service, we hope to help ease the pressures in hospitals by caring for people in the right place at the right time, helping to improve bed availability for people who need to be cared for in hospital and patient flow. This includes either preventing avoidable admissions into hospital or supporting early discharge out of hospital.
Staff outside of Gottom Manor Reablement Unit.
To help ease pressures, NHS Somerset has been working with Somerset County Council to set up reablement facilities which support patients that have been discharged from hospital, providing them with therapy and support to do things independently, and social worker support so that they can return home safely.
There are a total 155 beds in reablement facilities across different locations in Somerset. Many of our reablement facilities are located in local care homes where there is 24-hour support available. These facilities provide care for on average 200 people who are ready to be discharged from hospital, but cannot go home because they need additional care and support before they can safely return to the place they call home (whether in their own home or residential care).Find out more about Reablement Centres.
Discharge to Assess Service
This service supports people to recover and regain independence at home. People using this service are supported to leave hospital sooner, and more than 90% of people that use this service remain at home after hospital discharge.
Somerset Independent Living Centres
Somerset County Council has two Somerset Independent Living Centres in Shepton Mallet and Wellington.
These are open for appointment-only bookings where people can talk with the Council’s Social Care Occupational Therapy team and try out equipment and technology to make daily living easier. This amazing service supports more than 300 people each month offering a unique and personalised range of support for people leaving hospital and wanting to live independently at home.
Somerset County Council is working closely with colleagues in the voluntary community and social enterprise sector to help deliver the care people need to be able to stay at home.
How this helps Somerset patients and hospitals
These services help us free up beds in hospital for more patients to be cared for, who need to be in a hospital setting by providing health and care services and social care support services in the community.
The Somerset Ambulance Doctor Service
Somerset GP Matthew Booker beside his ambulance car
NHS Somerset is also funding one of the only Ambulance Doctor Car services in the country, where GPs go out to see patients who require more complex care when an ambulance is called out .
For many people who find themselves in the ‘999’ ambulance system, a visit to a hospital A&E department, or a hospital admission, may not always be best way to meet their health needs.
For some, a hospital admission may involve a substantial upheaval and won’t necessarily provide any additional benefit in terms of their health.
Through the Somerset Ambulance Doctor Service, when a patient or their carer calls 999, patients with more complex medical needs may be visited by a GP with senior clinical expertise in urgent and emergency care. The Somerset Doctor Car can provide access to additional senior clinical expertise, medicines, treatments and diagnostics (such as point-of-care blood tests and ultrasound).
The service is also on hand to provide an additional set of clinical skills to support ambulance clinicians in making what are sometimes very complex or finely balanced decisions.
Running since 2014, the Somerset Ambulance Doctor scheme is one of the longest established services of its type in the South West, and one of few such models of its’ type in the country. It is commissioned and funded by NHS Somerset and delivered by South Western Ambulance Service NHS Foundation Trust. (SWASFT).
How this helps Somerset patients and emergency departments
Since it was first commissioned, the service has treated over 11,000 patients, and treats on average 85% of patients at home, without the need for transfer to a hospital emergency department.
This service also helps to keep ambulances free to respond to life-threatening emergencies within the community. In addition to providing more options for patients, their families and carers, the scheme helps support more efficient delivery of urgent care across the whole system, saving the NHS an estimated £200,000 each year. Listen to Somerset GP Matthew Booker talk about the service here.
Ready to Go Units and Hospital at Home
Two of the initiatives Somerset Foundation Trust (SFT) has developed to help those who are medically fit be discharged safely are The Ready to Go units and Hospital@Home programme.
The Ready to Go units at the Musgrove and Yeovil District Hospitals are supporting people who are medically ready for discharge, to be ready to go home.
The Hospital@Home programme (also known as virtual wards) is where SFT cares for some patients at home safely, rather than being in hospital. A virtual ward is a safe and efficient alternative to NHS bedded care that is enhanced by technology. It supports patients to remain at home who would otherwise be in hospital to receive the acute care, monitoring and treatment that they need.
The service can help patients to complete their treatment or be monitored prior to surgery from the comfort of their own home
Working together across health and social care as one system
NHS Somerset’s Chief Executive talks to BBC Radio 4 about the reality of system pressures
Whilst putting innovative services in place is important, we are also working as a system to get a better understanding of the health and care needs of our Somerset Population. For example, we know that prevention and early intervention is key.
In Somerset although the average life expectancy is 84, 17 of those years are not spent in good health. So, a key focus for us, is how we work with communities and the voluntary services to help people stay well at home.
And it’s not just in hospitals and in social care that we are seeing increased demands for care. In April 2020, there were 172,653 GP appointments in Somerset – this had increased to 297,670 in September 2022 (including face to face, telephone appointments and home visits): A 74 per cent increase in GP appointments in last two and a half years.Read more about GP appointment figures in Somerset here.
How we’re asking the public to help
The NHS is facing unprecedented challenges. We need you to play your part and use services wisely.
By choosing the right healthcare service for your needs, people with minor illnesses will be able to be seen more quickly by using more local services such as Minor Injury Units or pharmacies. Find out how to choose the right service here.
