The Northern, Eastern and Western Devon Clinical Commissioning Group (NEW Devon CCG) and the Northern Devon Healthcare NHS Trust (NDHT) have published the data evaluation from the first eight weeks of the Torrington Community Cares pilot.
The importance of this evaluation is that the model of care had to be safe, effective and provide a good experience for patients. On all points the data for Torrington residents between 1 October and 26 November 2013 shows:
– 3 admissions: In eight weeks, there were three admissions to Torrington Community Hospital against 134 referrals into the community team
– No effect on A&E: There was no increase in Torrington resident attendances to A&E at NDDH in the 8 weeks
– +70 FFT score: The Friends and Family test score for patients receiving the home-based care service was +75 (against an informal benchmark of +60)
– 2765 visits: The community team made 2765 visits to patients in the 8-weeks
– Patients at the end of life: More patients are choosing to remain at home at the end of their lives than be admitted to hospital. In 2012 our teams spent an average of 5.1 hours with each patient. In 2013, this had risen to 11.8 hours per patient (131% increase).
– Of the 294 Torrington residents currently on the case load of the community team, 15 patients receive more than one visit per day, 19 one visit per day and 89 between once per day and once per week as clinically appropriate.
On 23 November, the inpatient beds at the hospital temporarily closed. The NHS has been carefully tracking patient journeys and monitoring the success of the home-based model of care.
Dr Chris Bowman, Vice Chair of NEW Devon CCG, “At this early stage, the data tells us that patients in Torrington are receiving a great service from the community teams and one which is proving to be a high quality clinical alternative to community inpatient beds. We are able to tailor the service according to the individual needs of patients, and provide a service to more patients than would be possible in Torrington hospital.
We are publishing this data at the eight week point to ensure we are running this pilot in an open and transparent way. I would encourage everyone to look at the data and see the results for themselves.”
Two papers, published here provide the raw data and also a narrative to accompany the data. The narrative answers the questions raised by the community:
- Have Torrington patients been disadvantaged through the absence of Torrington community hospital beds?
- Has the community team delivered the enhanced service?
- Are the patients and carers happy with the service they have received?
Kate Lyons, Director of Operations at Northern Devon Healthcare NHS Trust said, “The data collected so far bears out our passionate belief that the residents of Torrington would benefit from this enhanced model of community services, leaving us free to develop the hospital into a hub offering local services.
“Whilst we have seen a slight increase during the first 8 weeks in the acute spell, patients are no longer needing the stay in the community hospital which previously could have been around 30 days.”
The data collected and interrogated was identified using the agreed evaluation template. The evaluation criteria was developed using feedback from the community about their fears and aspirations and was agreed by the Oversight Group, consisting of public and stakeholder members.
The 8 week evaluation commenced on the 1st of October 2013.
The hypothesis being tested was that the vast majority of people if not all those referred to Torrington hospital, either by GPs or NDHT could have their care delivered in their own home by the enhanced community team.
Previously General Practitioners (GPs) or Northern Devon Healthcare Trust (NDHT) could make a referral to Torrington Hospital for an admission. From the 1st October those referrals could still be made, but rather than admit all patients to the hospital as the default, the referrals were triaged, by clinically-trained staff to explore the most appropriate form of care for each patient, taking into account the presence of enhanced services in the community.
This triage process was implemented throughout the 8 week period with 6 beds still open for admission if required. The arrangement to maintain the presence of beds during this 8 week period was agreed in response to questions, comments and challenges raised by individuals in the community. The community requested these beds as a “safety net”.
At the end of the 8 week period the beds were closed for the remainder of the 6 month trial and the enhanced model of community care continued with the triage arrangement also continuing as described above.
This decision was agreed and endorsed by the Oversight Group on 18th November 2013 on the basis of the report of community bed usage over the 8 week period (a total of 3 admissions).
After only eight weeks of the six month pilot, we are not able to produce all the data to support a full evaluation. All data will be available at the end of the six month evaluation.
All the data gathered for the 8 week period was matched to the same data over the same 8 weeks in 2012 and 2011 where it is available.