2017 National Audit of Intermediate Care Conference review

On Wednesday 15th November, we hosted the National Audit of Intermediate Care National Conference. The conference was chaired by Dr Duncan Forsyth, Consultant Geriatrician at Cambridge University Hospitals NHS Foundation Trust and Chair of the NAIC Steering Group. We also welcomed British Geriatric Society to exhibit at the event.

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Professor Martin Vernon, National Clinical Director for older people and integrated person-centred care, was first to the stage, asking ‘Can intermediate care make a difference?’ with reference to the Five Year Forward View. His presentation focused on current and long-term approaches to reduce demand and keep care systems effective. This included the need to embed frailty care in wards and involving people living with frailty in their care. Preventative measures, such as exercise and cognitive stimulation were also referenced in Martin’s presentation, reducing the risk of age-associated conditions.

The NHS Benchmarking Network’s Support Team followed with key findings for NAIC 2017. You can read more about the findings in the England Summary Report. Thank you to all organisations who participated in the audit. Commissioner participation was up 62% on NAIC 2015 and provider participation also increased since 2015, by 36%. The bespoke dashboard reports will be available in December, and you can access the benchmarking toolkit for NAIC now.

The positive deviance methodology, developed by the Universities of York and Leeds, was applied to the NAIC 2015 service user audit data set. This methodology identifies services performing exceptionally well, despite facing the same constraints as others. NHSBN visited three ‘positively deviant’ home based teams in 2016 who demonstrated exceptional improvement on standardised outcome measure.  Several common key characteristics were identified across these teams including feeling valued, team management and skill mix. This exercise will be repeated on the NAIC 2017 data set.

We then heard from Dawne Garrett, Professional Lead for Older People & Dementia for the Royal College of Nursing, alongside Programme Manager for the Network, Debbie Hibbert. They presented on the Patient Reported Experience Measure (PREM) – a questionnaire to understand what service users think of their intermediate care. Conclusions from the PREM included under-staffing in bed based services and a lack of appropriate information for service users; however, the percentage of service users who felt they were treated with respect and dignity was high. There is more information on the PREM within the England Summary Report.

We welcomed three good practice speakers for our afternoon sessions. Stockport CCG and Stockport NHS Foundation Trust provided a joint presentation on their Transfer to Assess practice, which involves four pathways to best meet the needs of the patient to improve active recovery. The improved support for home based recovery has had a positive impact on those requiring bed based care. Stockport have also focused on multi-disciplinary teams to support people’s recovery through the Transfer to Assess practice.

North East London NHS Foundation Trust followed with a presentation on their Intermediate Care redesign, implemented to reduce the average length of stay by half and to ensure all transfers happened within 72 hours of referral. Within this service redesign, they focused on their Intensive Rehabilitation Service and Community Treatment teams, making the move towards home based care, which has subsequently had a positive effect on bed based care.

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Pennine Acute Hospitals NHS Trust brought our good practice sessions to a close, presenting on their CASS Crisis Response activity. Their Community Assessment and Support Service (CASS) offers a credible alternative to A&E, being accessible 7-days a week with a 1-2 hour response time. Pennine Acute Hospitals highlighted the importance of coordinated and patient centred care throughout the pathway, an area touched upon throughout the conference and the direction of many trusts across the UK.

If you have any project queries, please contact Lucy Trubacik, Assistant Project Manager. Thank you to all who submitted to the project and attended the conference in both a delegate and presenter capacity.

If you are interested in any of our future events, please contact Emma Pruce.