Minutes:
Thirza Sawtell, Programme Director, and Dr Hilary Floyd, General Practitioner, spoke to a comprehensive paper circulated to Members of the Panel regarding the work of the Epsom Health and Care Board with specific reference to the Epsom Community Assessment and Diagnostics Unit (CADU).
Epsom Health and Care was a strategic/delivery programme within the Epsom locality of Surrey Downs CCG initially aimed at the over 65s. Whilst the needs of patients registered with the twenty General Practices that made up the Epsom locality crossed many of the partners’ organisational boundaries, these were defined by General Practice being the central component of people’s care coordination and the community’s use of Epsom General Hospital, in particular in relation to urgent and emergency care. The programme was based on the belief that:
· Care was better if provided around the needs of the individual;
· Care needed to be co-ordinated; and
· The system should work to support what people wanted by commissioning together outcomes, working together for those outcomes and sharing information.
The Epsom Community Assessment and Diagnostics Unit (CADU) was a new GP and clinical led initiative commissioned by the CCG and NHS England through use of the Prime Minister’s Challenge Fund. It aimed to integrate health and social care and to provide the over 65s in Epsom with rapid, on-the-day access to diagnostics, assessments, and community care in a single location. The Unit had only been up and running for a couple of weeks. Referrals to the Unit had so far been largely via GPs – complex cases which might usually end up in A & E – with a view to the patient going home with a package of care on the same day. It seemed to be going well. This was endorsed by the Chief Executive of the Epsom and St. Helier University Hospitals NHS Trust, Mr. Elkeles, who confirmed that referrals to the Unit had prevented 10 -15 emergency admissions in the last two weeks and welcomed this collaboration.
Sharing of information was a powerful tool in the work of the Unit. All clinicians on the CADU (with patient consent) would have visibility of a patient’s GP clinical record held by their practice and would use the same clinical system to develop an Integrated Care Record which would be shared with all partner organisations and sit alongside the GP’s clinical record in the practice. To facilitate this, a data sharing agreement had been agreed between all main providers. Work was currently being undertaken to integrate health and social care systems to facilitate access to relevant records.
The CADU was staffed by GPs, nurses from ESTH, therapists from CSH Surrey, social care and re-enablement managers from Surrey County Council and staff from the Red Cross with support from Districts and Boroughs. Some of the GPs employed to work at the Unit also worked in a General Practice in the locality and a couple of GPs had expressed an interest in specialising in the work of the Unit. However, responsibility for a patient still lay with the referring GP.
The Unit was currently funded for 18 months. City University had been commissioned to undertake a formal evaluation of the success of the Unit after 3 and 6 months. It was recognised that the health/social care needs of the population were growing/changing/diverse but it was hoped that, if successful, the initiative would be able to grow with demand in conjunction with the community medical teams.