|Contact||Wayne Goddard, Head of Strategy and Development, NHS Doncaster CCG|
|Address||Sovereign House, Doncaster, DN4 5HZ|
This service is for older people and younger people with dementia who attend an Emergency Department (A&E), a Medical Assessment Unit (MAU) or who are admitted to Acute Trusts.
What was your starting point?
Data that showed longer length of stay (LOS), poorer outcomes, readmission, poorer experience and increase in incidents and complaints.
What change was introduced and how was this done?
Despite the debate caused by the Operating Framework and now Currency development around who should commission Liaison Services, we recognised as a partnership there were not only mutual risks but mutual gains to be had by addressing the problem.
What resources were required?
Through reconfiguration of current resource and additional funding from “reablement and the Acute Provider we have commissioned a multidisciplinary OPMH Acute Liaison Service that not only attends A&E and helps prevent admissions but also promotes better care and better outcomes and experience for those who need to be admitted.
The team consists of:
- Dedicated Consultant time
- 6 full time band 6 nurses
- a full time MH physio
- 0.5 WTE Clinical lead band 8a
- Pharmacy support, and
- Administrative support
This costs £330k
What impact have you had?
We piloted and formerly and independently evaluated the service. Findings showed a reduction in length of stay by 2 days and no increase in readmissions despite this. Reduction in falls and particular #NOF, increased satisfaction and experience.
Cost saving ratio of at worst 5:1
The video below illustrates the far reaching benefits of the OPMH Liaison Service.
The service is now substantively commissioned by the partnership.
What challenges did you face and how were these overcome?
Getting partners to the table and agreeing a commitment and memorandum of understanding; once this was done determination and grip was key to make this happen. Formerly and independently gathering the data and demonstrating value was crucial to ensure substantive funding.
How can the change be sustained and spread?
A full evaluation report is available upon request from Wayne Goddard, Wayne.Goddard@Doncasterpct.nhs.uk. This has been disseminated through the Yorkshire and Humber Dementia Leads Group.
What have you learned?
Our key learning points include:
- Doing things together is possible,
- Integration is possible and it works,
- Keeping the patient at the forefront of our mind works