A rapid response service led by community matrons is helping to reduce GP callouts and hospital admissions across Middlesbrough, Redcar and Cleveland.
The rapid response service, delivered by community staff from South Tees Hospitals NHS Foundation Trust, was initially launched three years ago as a nurse-led service to assess patients in their own homes.
The service has now been further enhanced with the addition of community matrons who have more advanced clinical skills and particular expertise around patients with long term conditions. Since their introduction GP referrals to the service, which runs from 8am to 11pm seven days a week, have increased from around three a month to around 16 a month.
“We have seen a big increase in referrals,” said Val Gair, the trust’s head of nursing for integrated medical care.
“The GPs have a lot of confidence in the community matrons as they can offer advanced clinical skills and nurse prescribing as well as being able to put in place a management plan for the patient.
“It’s easing pressures on the system as GPs don’t have to be called out or admit the patient to hospital. Previously around 75% of these patients would have ended up going into hospital.”
South Tees Clinical Commissioning Group has seen a 3.9% reduction in emergency admissions over the last year which compares to a 3.9% increase nationally.
The changes to the rapid response service have been introduced as part of South Tees Clinical Commissioning Group’s IMProVE programme (Integrated Management and Proactive Care for the Vulnerable and Elderly).
Dr Ali Tahmassebi, lead for the IMProVE programme said: “It’s great to see our rapid response service developing further. The additional expertise brought to the team by community matrons enables more of our patients to be supported at home rather than be admitted to hospital unnecessarily.”
Rapid response patients are monitored for 72 hours before either being discharged or placed under the care of their local community matron.
Referrals come from GPs or NHS 111 – the NHS non-emergency number – and must be responded to within two hours. Patients should call 111 if they urgently need medical help or advice but it’s not a life-threatening situation.
Eighteen community matrons cover the Middlesbrough, Redcar and Cleveland area and the service links in with the integrated community care team for patients who require long-term care.
The service has already generated positive feedback from patients. Comments from a recent patient survey included: “Aftercare from the nurses was brilliant, I was really looked after at home” and “Everyone could not do enough for me.”
Dr Janet Walker, chair of South Tees CCG added: “The service supports patients to manage through the most difficult days of their acute illness at home. Patient feedback has been extremely positive and patients and carers clearly value the care provided and avoiding admission to hospital.”