‘The Early Deterioration in Home Care project in Nottingham and Nottinghamshire showcases innovation in technology working in a local setting to provide value for individuals and for the system as a whole.
Nottinghamshire County Council wanted to enable people to stay at home with a good quality of life for as long as possible. It saw that the best way to do this was to provide a homecare service that supported people to stay living independently at home while receiving support to maintain their health and wellbeing.
They saw the solution in the adoption of a digital solution on which health and local authorities could collaborate. The Early Deterioration in Home Care project group was born as a collaboration between Nottinghamshire County Council, Fosse Healthcare, Nottingham and Nottinghamshire CCG, Birdie Care (homecare software provider), East Midlands Academic Health Science Network (AHSN) and Nottinghamshire Alliance Training hub (NHS-led training body for health and social care in Nottingham and Nottinghamshire) and the local PCNs.
The project needed to understand the implications of developing a digital system solution, which could be adopted throughout the home care market. It had to be used to connect home care providers with GPs, emergency services, and the NHS to proactively identify and treat ‘soft sign’ changes of deterioration before they became larger critical care/medical concerns.
The success of the project is due to getting strong partnerships in place across health and social care. The PCNs were particularly important as the lynchpin allowing the sharing of information and observations about a person in a digital format as part of the clinical care pathway.
The benefits of the collaboration have been that:
• People are receiving the care they need faster – for example, through earlier identification of infections followed by remote prescription of antibiotics;
• People and their families feel more assured that concerns are adequately followed up, particularly in a time where many have not been able to visit GP services for many months due to Covid-19;
• Care workers can address issues in brief telephone consultations with GPs, whereas previously this would have resulted in several hours of work for GPs through unnecessary home visits;
• GPs and care workers are now developing new partnership-based working relationships. For example, where a GP asks the care worker to provide regular blood pressure observations for monitoring a patient over a period of time; and
• Care workers can engage more closely in supporting care people with health concerns and experience a new professional development opportunity due to additional training and responsibilities – this attracts new talent and lowers attrition.
It has been developed across the one ICS footprint and could be replicated across others.
The development of the Birdie Home Care App has allowed early detection of any problems and a clinical or social care response at an early stage to avoid any deterioration. This creates value for the person and for the health and care services as a whole, because it allows them to work in a proactive, rather than reactive, mode.
While technology is at the centre of this project, its real beating heart is the collaboration across the statutory health and local authorities and the private sector. The approach of joint endeavour, in which the product was developed iteratively and developed, has borne fruit, and there is potential for greater benefit. The partners are now also exploring other projects such as direct integration of data from the Birdie App into the Nottinghamshire care record and expanding to other pathways, such as discharge home to assess.’