Acute Frailty Intervention Team HEW Frailty Workforce Development - - PowerPoint PPT Presentation

Acute Frailty Intervention Team

HEW Frailty Workforce Development Team Meeting 17 May 2017

South Hampshire Vanguard Multi-specialty Community Provider

Where are we now?

Enhancing Patient care:

• Service is embedding well, with positive outcomes; from patient

experience and initial GP/SCAS feedback Supporting Staff:

• Considerable progress in demonstrating model but much more support

needed to improve delivery; including standardising outcomes/practice and further training on multiple GP IT systems

• There have been a number of unforeseen administrative challenges with a

service yet to be commissioned; HR process, contractual/clinical governance conflicts and organisational barriers (stretched resources) Financial Sustainability:

• Financial impact looking positive but need longer term to evaluate
• utcomes

Project update - AFIT

• Staff appointments
• Training & Education
• Milestones, objectives reached
• Activity to date
• Patient Feedback

Staff appointments - Challenges

• Recruitment process for ‘Locum’ GP

(employing GPs due to type of contract)

• Associate Practitioner – Foundation Degree

(requirement impacts on available pool of applicants)

• Differences in Organisational recruitment

style and processes (needs a values based recruitment)

Staff Appointments – The Team

Geriatricians: Dr Gill Turner and Dr Marianne Plater; WNF Locality Frailty Lead: Dr Ed Reeves Associate Frailty Consultant Practitioner: Debbie Crewe; Associate Practitioner: Sarah Holloway Trainee Practitioner: Lucy Lewis Frailty GPs: Dr Iain Redmill, Dr Victoria Wright, Dr Sian Brett, Dr Jabir Merali SCAS Technicians: John Cross, Steve Gordon; ICT Support: Eleanor Corbett, Allison Collins, Trina Cooper

Training & Education

• GPs & Practices:
• Local Delivery Group & Clinical Locality Group:

§ Presentations on Scope & Criteria (exceptions/inclusions) § Challenges (technology & recruitment)

• SCAS: Crew training sessions:
• 4 x sessions in Feb 2017, 5 x sessions in Mar 2017, 3 x

Sessions in April 2017:

• AFIT:
• Self supportive (clinician to clinician)
• Mentoring
• AFIT Away Day – 26 April 2017

Training & Education - SCAS Crew Training

• Aimed to:
• Introduce the AFIT project
• Who it’s aimed at
• How it will work
• Focus on frailty and what may cause an episode of

decompensation followed by the inclusion and exclusion criteria that the crews needed to follow

• Focus on the process and how feedback from the crews was

imperative to demonstrate how well the project works

Training & Education - AFIT Away Day 26 April 2017

Training & Education - AFIT Away Day Outcomes & Actions

Enhancing Patient care:

• Improved assessments
• Improved efficiencies
• Improved processes
• Long Term Management

Supporting Staff:

• Standardising record keeping
• Lessons Learned and Shared Learning
• Review/reflections

Financial Sustainability:

• Future expansion – WHCCG business case

Training & Education - AFIT Away Day Shared Learning

• Frailty Awareness
• Role of CGA
• Where AFIT fits within frailty process
• Assessment of gait and mobility
• Advanced Care Planning Discussions
• Considering Cognition – using MOCA inc. MOCA for

visually impaired (http://mocatest.org)

Milestones, objectives reached

Project milestones and activities delivered: When achieved (Timescale): 1 Task & Finish Groups (concept & development) 14 July 2016 – 8 December 2016 2 Proof of Concept 18 July – 12 August 2016 3 Frailty Workshop 19 October 2016 4 Recruitment of Consultant Practitioner in Frailty and SCAS Technician October-December 2016 5 Delivery Group (to implementation of Pilot) 12 January – 9 March 2017 6 Recruitment of Frailty GPs January-February 2017 7 Recruitment of Band 4 Associate Practitioner February-March 2017 8 Process Criteria Brief & update to WNF Clinical Locality Group 25 January 2017 9 Memorandum of Understanding in place 3 February 2017 10 Update to Local Delivery Group (BLC Board) 14 February 2017 11 AFIT Pilot start 6 March 2017 12 AFIT Team Away Day (training and capture of lessons learned) 26 April 2017 13 Communications Campaign (BLC, Practices and Local Media) 28 April 2017

Milestones, objectives reached cont. Activity as at 10 May 2017

Patient Feedback

Patient Feedback

“We were told of this new service at 10pm on a Wednesday night by ambulance service. AFIT were with us by 10am next morning - That is ‘service’ excellent” “The Frailty team were most professional & very thorough at assessing my Mother’s needs at this time – thank you all.” “Everyone was so kind and explained to me. Thank you all.” “The two medics that came to see my elderly neighbour were very friendly and very kind to her. They treated her with dignity and respect. Fantastic service.” “The two team members who came to see my husband were very polite and efficient, and I much appreciated this service.”

Questions