Integrated community nursing services are being developed across Solihull as part of a project to enhance community services.
The first phase was launched in July 2015 which focused on restructuring community nursing. There are six community nursing teams across the borough each linked to a number of GP practices. They deliver community nursing services to patients in their own home, including people who are at the end of their life. They also provide a rapid response (within two hours) to provide urgent care and support to those at immediate risk of an admission to hospital.
Phase two, which will be launched later this year, will see further work to integrate community nursing, primary care, social care, mental health and other services.
Evidence is being collected around what is working well in other areas, in order to inform the development of phase two. This includes looking at integrated assessments and care planning, care coordination and IT solutions to support staff to share information and coordinate care.
The project has been developed as part of the Integrated Care and Support Solihull (ICASS) programme, a joint initiative between Heart of England NHS Foundation Trust, Solihull Metropolitan Borough Council, Solihull CCG and Birmingham and Solihull Mental Health NHS Foundation Trust.
Helen Kelly, head of Integrated Care and Support Solihull, said: 'Over recent years, our thinking about how care and support should be delivered has changed. Local feedback has shown that our current services are seen as complex, fragmented and difficult to navigate. Some patients and service users are visited by several different professionals, leading not only to potential confusion but also to a duplication of effort on the part of services.
'The Integrated Community Teams (ICT) project has been developed in response to this. The project is part of the ICASS programme and is critical to us achieving our 'Solihull – Together for Better Lives' vision.'
This vision aims to bring several organisations together to enhance community services for patients.
The aim is that staff will work together more effectively and efficiently across organisational boundaries, in services that are less fragmented and easier to navigate. Patients will receive care and support that meets their health, social and emotional needs while also helping them to be as independent as possible, to reduce avoidable admissions to hospital and care homes.