Strategic priority six: Right care, right place, right time
As part of making sure people receive the right care in the right place at the right time, we want to ensure people are supported to live as independently as possible. We are committed to ensuring people are supported at home and within their communities whenever possible and are admitted to and stay in hospital only when clinically necessary. Central to our thinking is working towards the provision of care tailored to the individual, in a place which best provides this care and as close as possible to when it is required.
The Home First project is helping to avoid the need for hospital admissions and supporting people to get home as quickly as possible once it is safe for them to do so. We aim to embed the Home First ethos, with a dedicated staff team, into business as usual by March 2022.
Between April and August 2020, the Home First teams were dedicated to supporting the covid-19 response by helping people out of hospital and back home when it was safe to do so. This resulted in historically low delayed discharges. Since then we have supported the introduction of Home First navigators in both the Royal Infirmary of Edinburgh and the Western General Hospital to support earlier discharge planning and work with Home First teams in the community. From April 2020 the Home First team has been screening all referrals to intermediate care to ensure the patient is on the right pathway to have their care needs met, with a Home First co-ordinator successfully piloted within these intermediate care facilities to support this work.
The Home First team also supported the national drive to redesign urgent care initiated by the Scottish Government, with new pathways implemented in January 2021. Approximately 20% of all people who present to the front door of acute services could have their assessment, care and treatment elsewhere. The redesign of urgent care has implemented a single point of contact via NHS24 to triage patients and redirect them to the most appropriate service to meet their care needs. We have implemented an urgent therapy and social care pathway to support urgent referrals relating to social care. This pathway has been live from January 2021 and will be evaluated iteratively to ensure its success.
Carers are a vital partner in supporting the most vulnerable people in society and were significantly affected by the restrictions put in place during the pandemic, with limited access to many of the services they rely upon, including respite care. Carer Centres continued to offer emotional support, information and practical advice to carers, including connecting carers with a service that’s right for them. The Edinburgh Carers Strategic Partnership Group continues to work together to implement the Edinburgh Joint Carers’ Strategy 2019-22 and ensure support is in place to mitigate the impact of the pandemic on carers.
During 2020/21 we also undertook a comprehensive commissioning exercise to establish new carer support contracts, which commenced in January 2021. These have been designed to expand supports that were already valued and deliver against the six key priority areas in the Edinburgh Joint Carer’s Strategy 2019-22: Identifying Carers; Information and Advice; Carer Health and Wellbeing; Short Breaks; Young Carers; and Personalising Support for Carers. They include additional supports for carers to have a break from caring.
Contracts were awarded to four lead providers, with a value of £17,373,169 over 8 years. Through encouraging providers to consider a collegiate approach, the contract award has supported the development of a Carewell Partnership, with a lead provider and four other providers, to deliver carer health and wellbeing support.
Our Assistive Technology Enabled Care (ATEC 24) service uses technology to help people live safely in their homes for as long as possible. This is a hosted service which operates on a Lothian-wide basis. The importance of this service has been highlighted during the pandemic when it has been more difficult to physically visit those in need of support.
In 2020/21, 1,200 new telecare installations were completed. Our telecare service responded to 550,000 alarm calls, with 11,500 emergency intervention visits.
We also established a ‘click and collect’ service for equipment to supplement our existing delivery service, with over 116,000 essential items provided across Edinburgh, Midlothian and East Lothian in 2020. An estimated 66,000 of these were provided to Edinburgh residents.
In 2020-21 we commissioned a new suite of sensory impairment community-based services. This included commissioning of specialist deaf social work services, deaf equipment service, eye clinic support service, rehabilitation and mobility service for people with sight loss, and administration and management of the Certificate of Vision Impairment register. Delivery of social work for people with vision impairment was brought inhouse to our locality teams, supported by interactive visual impairment awareness training delivered to 150 locality staff.
Contracts for deaf services were awarded to local provider Deaf Action commencing October 2020 to run for 3-5 years. The existing sight loss services were extended by 6 months to take account of covid-19, with new sight loss services commenci
ng in April 2021 with our new community partners, also for 3-5 years. Sight Scotland (formerly Royal Blind) won the contract to deliver both rehabilitation and mobility training for people with a vision impairment, and the management of the Certificate of Vision Impairment database on behalf of the City of Edinburgh Council, while Visibility Scotland will deliver the Patient Support Service at the Princess Alexandra Eye Pavilion. Both organisations have great commitment to working in partnership with us and each other to deliver high-quality and seamless services to the person with sight loss.