Better Together – November 2022

Virtual ward at HRCH and Kingston Hospital

Virtual wardWe recently heard from a mother and daughter who were very happy with one of our integrated services. Watch the video

Ann was a patient for two weeks with our Kingston and Richmond virtual ward in the community and her daughter, Caroline, was involved as her carer.

The ward provides hospital care for patients in the comfort of their own homes, or wherever they usually live. Patients are hooked up to digital kits that communicate directly with specialist staff at Kingston Hospital, who can monitor virtually.

During COVID, all acute trusts and community services were asked to set up virtual wards. Across Richmond and Kingston community health services, housing and Kingston Hospital, we set up a COVID virtual ward in a matter of days.

Now, the virtual ward is for patients with long-term respiratory conditions or acute respiratory infections, as well as COVID and heart failure patients.

Ann said: “You feel confident because the hospital knows exactly how you are, one-to-one, rather than a whole load of people. I just think you do get better at home.”

Caroline added: “The reassuring thing [after being discharged] was they were there if there was a problem and we couldn’t get in touch with our GP, or we couldn’t get an appointment.

“You’ve got their number and they will do their best to fast track you somewhere or advise you on the phone what to do in case of an emergency.”

Paramedics and nurses pair up to respond to elderly patients this winter

LAs pilot schemeParamedics at London Ambulance Service (LAS) are being paired with nurses from community health providers in south west London to respond to elderly and frail patients in a ground-breaking pilot scheme to prevent delays this winter.

The new teams are working together in urgent community response cars and aim to treat patients at home, rather than taking them to hospital in an ambulance.

The initiative includes community nurses from HRCH and Your Healthcare.

Paramedic Michael Budd said: “A fall can result in an injury that can be painful but also stressful if the patient doesn’t want or need to go to hospital. By combining the skillsets of an emergency paramedic and a community nurse, we can tailor our assessment, treatment and follow-up plans, meaning many of these patients can be really well cared for at home.

“Our patients are getting a quick and effective response while we are building strong relationships with our community partners, learning from each other and sharing clinical perspectives and experiences.”

Around 10 per cent of 999 calls to London Ambulance Service are from older people, especially in winter, when more people fall over.

There are three cars running from 8am to 8pm every day and LAS and community partners plan to expand the scheme across the capital.

As well as responding to fallers, the teams will help elderly people with minor wounds, injuries, infections and catheter problems, as well as those needing palliative or end of life care.

Nurses recruited to the scheme already work in the community and are familiar with local health and social services, which means they can refer patients for longer term help.

Sandra Brandon, lead nurse practitioner at Your Healthcare, said: “Working with London Ambulance Service and using our combined paramedic and nursing skills means we can assess and treat patients who do not need to go to hospital. We can also refer patients to other community services, such as occupational therapy, or arrange a follow-up visit as necessary.”

In the first four weeks of the pilot, the community response teams treated 300 people at home.

In each case, this avoided an ambulance being called and a trip to hospital – about 60% to 70% of patients getting the right care at home and freeing up hundreds of ambulances to respond to life-threatening emergencies.

This is making a real difference to patient experience – not to mention relieving the pressure on hospitals and ambulances!

Shared objectives for HRCH and Kingston Hospital

For the first time, Kingston and HRCH have agreed a set of joint objectives for 2022-23.

The four objectives are:

  • to be great and inclusive places to work for our people
  • to deliver high quality care
  • to be sustainable and live within our means to ensure lasting improvement
  • to deliver care that connects organisations, within systems and partnerships

Shared objectives

Across HRCH and Kingston, everything we do will also be shaped by four joint principles:

  • equality, diversity and inclusion
  • quality improvement
  • reducing health inequalities
  • working collaboratively with partners

Committee in Common

In April 2022, we brought the executive leadership teams of Hounslow and Richmond Community Healthcare and Kingston Hospital together as one, remaining individual trusts.

However, they established a Committee in Common, which is empowered to make key strategic decisions with the benefit of expertise and insight from across the full range of services.

The committee met properly for the first time on 26 October to discuss a range of important issues and you can read the papers here.

Or watch the video