Lead Responsibility | Project Title | Project Details: | Anticipated Outcome: Reduce delays over 6 weeks to zero by April 2008 Reduce the number of delays in short-stay beds to zero by April 2008 Prevent unnecessary emergency admissions Speed up assessment process and discharge planning Ensure resources are available to fund care home and domiciliary care Ensure quarterly sustainable reductions are made | Cost Total DDAP Allocation: £121,000 |
Roma Paton, Service Manager Older People, Orkney Islands Council | Night Support Service | Night Support Service Description of Project: The Night Support Service is managed within OIC Home Care. It provides routine and emergency night care visits to people with high dependency needs to enable their continuing support at home. It also provides short term monitoring and care assistance in conjunction with the Rapid Response Service. Impact Project will have: The service will enable people to be maintained in the community, who would otherwise require care home admission, reducing pressure on care home places which is a key factor in the Delayed Discharge whole system. The service is also an element of crisis care, preventing inappropriate hospital admission. Who will benefit and how: People with dementia who require late night tuck in or night time check visits, helping to keep them safe at home; people with significant disability or physical frailty who need late night tuck in, assistance with toileting, or emergency on call assistance, to enable them to be supported in the community; people with a critical short-term health problem who need social care assistance during the night. What data is collected and how often: Monthly reporting of: Numbers of service users Numbers of visits Outcomes - - Service users maintained in the community - Admissions to hospital or care home prevented - Unsuccessful attempts to prevent hospital or care home admission, and length of any delay achieved - Service users enabled to die at home - Unmet need Key risks to achieving satisfactory outcome: Escalating unmet need due to increasing demand and lack of sufficient resources Difficulties in achieving adequate geographical coverage in remote and rural island setting Difficulties with staff recruitment and retention | Night Support Service Prevent unnecessary emergency admissions Reduce the number of delays in short stay beds to zero by April 2008 Ensure resources are available to fund home care* Ensure quarterly sustainable reductions are made *to make documents clear and understandable, "home care" is used locally, rather than "domiciliary care" | Night Support Service Total cost 2006-2007: £46,975 2007-2008 est: £48,150 DDAP Funding: £46,975 OIC Funding 2006-2007: £ 0.0 2007-2008 est: £ 1,175 |
Roma Paton, Service Manager Older People, Orkney Islands Council | Rapid Response Home Care Service Development | Rapid Response Home Care Description of Project: This is a new initiative designed to enhance the existing Rapid Response Service, by extending the hours of staff availability from 70 per week to 103.5 per week with on call at nights; the introduction of a shift pattern to improve staff retention (as turnover has impacted negatively); and the extension of service from Orkney Mainland to the islands. Impact Project will have: Reduce pressures on mainstream home care services which have covered shortfall in RR staff availability; extend service throughout Orkney; reduce unmet need; facilitate early discharge project for hip surgery Who will benefit and how: People with short term health care needs who can return home from hospital early with intensive home care to complement community OT and physio; people at risk of inappropriate care home or hospital admission who can be provided with intensive crisis care at home; people in the islands who were previously without a service; people who may benefit from early discharge following hip surgery. What data is collected and how often: Monthly reporting of performance data: - Services provided - Admissions prevented - Delays accelerated - Unsuccessful attempts to prevent admission and length of any delay achieved - Service users enabled to die at home - Unmet needs Biennial Reporting also via JPIAF 11 LITS Key risks to achieving satisfactory outcome: Escalating unmet need due to increasing demand and lack of sufficient resources Difficulties in achieving adequate geographical coverage in remote and rural island setting Difficulties with staff recruitment and retention | Rapid Response Home Care Prevent unnecessary emergency admissions Reduce the number of delays in short stay beds Ensure resources are available to fund home care * Ensure quarterly sustainable reductions are made *to make documents clear and understandable, "home care" is used locally, rather than "domiciliary care" | Rapid Response Home Care Total cost 2006-2007: £21,756 (Total service budget £61,974) 2007-2008 est: £22,300 (Total service budget £63,524) DDAP Funding: £16,025 OIC Funding 2006-2007: £ 5,731 (Total service £45,949) 2007-2008 est: £ 6,275 (Total service est. £47,499) |
Mary Stewart, Joint Service Manager, Occupational Therapy, Orkney Islands Council/NHS Orkney | Additional Occupational Therapy Service | Occupational Therapy Description of Project: The 0.72 post of the Occupational Therapist is based in the Balfour Hospital. The post provides OT to identified patients within the acute wards along with the other part-time OT employed by Health. The post has been augmented by 6 hours from another staff member who reduced their hours. Now totaling 0.89 As well as focusing on rehabilitation of the patients the OT will carry out appropriate home visits prior to discharge. The OT also provides therapy intervention to the Rapid Response Team. Impact Project will have: The OT intervention provides rehabilitation of patients and facilitates the seamless and planned discharge of patients. The contribution through the Rapid Response team allows people to remain at home despite decreasing levels of function ,and often at a time of crisis. Who will benefit and how: People who have been identified through the Rapid Response Team as at risk of admission to hospital, may have the OT provide appropriate equipment and/or intervention to enable them to stay in their home, and continue to manage their every day tasks while improving or maintaining their functional levels. Patients in hospital who have been recognized as medically able to return home, will have the OT assess their functional levels and if necessary carry out a home visit, usually taking any appropriate equipment on the visit to ensure an efficient and seamless discharge. What data is collected and how often: Monthly statistics are collected by the OT service, and individual statistics for each therapist can be identified. Statistics for intervention as part of the Rapid Response Team are collated through that service, on a monthly basis. Monthly reporting of performance data: - Services provided - Admissions prevented - Delays accelerated - Unsuccessful attempts to prevent admission and length of any delay achieved - Service users enabled to die at home - Unmet needs Biennial Reporting also via JPIAF 11 LITS Key risks to achieving satisfactory outcome: Maintenance of staffing levels, especially as the OT service to hospital acute and rehabilitation wards, currently has staff on maternity leave. Increasing demand on the staffing resources and balancing this between input to the Rapid Response and the ongoing OT intervention to the ward areas. | Occupational Therapy Prevent unnecessary emergency admissions. Ensure quarterly sustainable reductions are made Reduce the number of delays in short stay beds to zero by April 2008 | Occupational Therapy Total Cost 2006-2007: £29,750 Estimate - no uplift or adjustment yet from Agenda for Change. 2007-2008 est: £30,420 Estimate as no adjustment under Agenda for Change. DDAP Funding £19,500 NHSOrkney Funding 2006-2007: £10,250 Estimate as above. 2007-2008 est: £10.470 Estimate - as no adjustment under Agenda for Change. |
Peter McKellar, Superintendent Physiotherapist, NHS Orkney | Additional Physiotherapy Service | Physiotherapy Description of Project: The 0.5 Physiotherapist post is based in the Balfour Hospital providing input to the Rapid Response Team and also providing additional hours to the community physiotherapy services to facilitate Early Hospital Discharge and to continue developing the Falls Prevention Programme. Impact Project will have: The Physiotherapist post provides rehabilitation through working in the Day Hospital, identifying movement, balance and co-ordination deficiencies, applying appropriate therapy as soon as possible to hopefully negate the need for a hospital admission. Within the Rapid Response Team the physiotherapist is an important member of this multi-disciplinary team, involved in assessments, training, treatments and service planning and developments. Who will benefit and how: People who have been referred to the Rapid Response Team, and who are at perceived risk of admission to hospital, may have physiotherapy input to improve their balance, strength and co-ordination. People who have had Colles fractures, can often indicate a higher risk of falling ,are referred to this physiotherapist and encouraged to then attend the Falls Programme. What data is collected and how often: Patient numbers are submitted monthly to the Rapid Response Co-ordinator and the patient Care co-cordinator. Monthly reporting of performance data: - Services provided - Admissions prevented - Unsuccessful attempts to prevent admission and length of any delay achieved - Service users enabled to die at home - Unmet needs Biennial Reporting also via JPIAF 11 LITS Statistics are also submitted to the Physiotherapy administrator for the Day Hospital, Falls Group, and community patients. Key risks to achieving satisfactory outcome: This post formalises the need for quick and urgent intervention to people who are potentially in crises at home. There is a key risk in staff being available to provide this input, particularly as this post is only part-time. | Physiotherapy Prevent unnecessary emergency admissions Ensure quarterly sustainable reductions are made | Physiotherapy Total Cost 2006-2007: £18,300 Estimate as no adjustment yet for Agenda for Change 2007-2008 No figure available DDAP Funding £16,000 NHSOrkney Funding 2006-2007: £2300 No adjustment for Agenda for Change 2007-2008 No figure available No adjustment for Agenda for Change |
Roma Paton, Service Manager, Older People Orkney Islands Council | Additional care home places for specialist dementia care | Dementia Care Places Description of Project: The provision of Social Care staffing to support 3 additional dementia care places at St Rognvald's House. Impact Project will have: The provision of these extra care home places for those with dementia should facilitate the discharge, from hospital of those assessed as requiring a care home place and prevent inappropriate admission to hospital. Who will benefit and how: Care home places are available for those service users with dementia who can no longer be supported in their own home. What data is collected and how often: Occupancy rates of these places are collected as part of a statutory reporting mechanism. Waiting lists for Dementia Care including numbers of people waiting in hospital are reported weekly Discharge Delays are reported via National Census Key risks to achieving satisfactory outcome: Due to the ever increasing demand for care home places the risk is not that we will not be able to accommodate service users with dementia, but that there are insufficient places available to facilitate and prevent delayed discharges. | Dementia Care Places Reduce delays over 6 weeks to zero by April 2008 Reduce the number of delays in short-stay beds to zero by April 2008 Prevent unnecessary emergency admissions Ensure resources are available to fund care home places Ensure quarterly sustainable reductions are made | Dementia Care Places Total Cost 2006-2007 est: £21,000 2007-2008 est: £21,500 DDAP Funding £20,500 OIC Funding 2006-2007 est: £500 2007-2008 est: £1000 |
Margaret Graham, Patient Care Coordinator, NHS Orkney | Home from Hospital Service | Home from Hospital Service Description of Project: Red Cross Volunteers provide escorts for patients returning from Aberdeen Hospitals or from Balfour Hospital to and from islands, also escorting patients awaiting onward flights at airports Impact Project will have: Prevent delays in discharge Who will benefit and how: Vulnerable patients traveling on their own to or from hospita What data is collected and how often: Number of patients benefiting from service collected monthly Key risks to achieving satisfactory outcome: Lack of volunteers | Home from Hospital Service Reduce the number of delays in short-stay beds to zero by April 2008 Ensure quarterly sustainable reductions are made | Home from Hospital Service Total Cost 2006-2007: £2000 2007-2008 est: £2000 DDAP Funding £ 2000 |