A self care project for older people with long-term conditions has halved their hospital admissions.
The Supported Self Care project coordinated by Bristol Community Health and the Lennard Practice in Bedminster, provides support for patients, coordinates care, advises and signposts individuals to services most aligned to their needs.
For patients with the highest acuity the admissions into hospital were reduced by 50% and for the cohort with the lower level of acuity their admission rates were also reduced by 50%.
Hannah Eklind, a community matron and clinical lead for the project at Bristol Community Health, said that the patients felt that their confidence in self-management was increased through the use of the technology and support for the hub. ‘The patients felt more reassured in managing their conditions and took more of an active role in their self-care,’ she said.
The project revolved around three different types of technologies. These included a personal health channel installed on the patients TV or on a tablet, a text messaging system which sends messages once or twice a day to request a vital sign reading, symptoms and to give health messages.
There was also a smartphone app which helps patients and carers to understand and manage the health conditions better. All the three services are monitored by clinical staff at a central hub.
Patients were identified through looking at the caseloads of the community matron and the practice nurses and direct referrals from the GP. In total 93 patients were enrolled across the service.
The programme was based from a community telehealth pilot in Bristol which was evaluated by Bristol CCG and will be further evaluated by the University of Bristol.
Ms Eklind said that they were currently looking at ways to roll the project out across the whole of Bristol.