Care home residents in Rushcliffe Nottinghamshire who received an ‘enhanced’ care package through Principia, an NHS multi-specialty community provider, attended A&E 29 per cent less frequently than similar care home residents in other parts of the country.
They were also admitted to hospital as an emergency 23 per cent less often. These are the main findings of the first statistical analysis by the Improvement Analytics Unit – a joint initiative between the Health Foundation, an independent charity, and NHS England.
In its report published recently, the Health Foundation says the positive results in Rushcliffe are likely to be the result of higher quality care being provided to the care home residents by Principia, one of 50 NHS vanguard sites in England.
The Improvement Analytics Unit was set up in 2016 as a three year partnership between NHS England and the Health Foundation to help improve the way care is delivered. It provides rigorous data analysis and insight into whether new ways of delivering care, for example, as part of major national initiatives such as the NHS new care models programme, are having a positive impact for patients. Analyses produced by the unit are one of a range of complementary evaluation techniques being used by NHS England.
Principia is a multi-speciality community provider (MCP) vanguard, based in Rushcliffe, and is one of 50 sites to receive national funding to develop new, innovative models of care. Principia’s enhanced care package, introduced in April 2014, ensured care home residents had regular visits from a named GP and independent support from Age UK Nottingham and Nottinghamshire. Greater support for care home managers and community nurses was also provided, for example through a peer-to-peer network.
The report says that while the positive results are likely to be the result of higher quality care, it is unclear whether the enhanced care package itself or some other changes to care delivery were responsible for the good results.
Adam Steventon, director of data analytics at the Health Foundation and one of the report’s authors, says: “In Rushcliffe, the analysis showed that care home residents in the study were significantly less likely to attend A&E or be admitted to hospital in an emergency than residents in other similar care homes. These results are good news for the Rushcliffe residents and good news for Principia.
"By enabling clinicians, care home staff and the charity sector to work together across organisational boundaries, Principia has helped achieve better care for care home residents, including fewer emergency hospital admissions. They have also achieved greater integration between health and social care services.
“The NHS is under enormous pressure to find new ways of delivering better care with limited resources. It is more important than ever that services are given the opportunity to develop new ways of delivering care. Robust evaluation enables the NHS to learn from and continue to improve what is working well.”
Samantha Jones, director of the NHS New Care Models Programme, says: “The team at Principia vanguard are working very hard to improve the care they deliver to local people, as well as to prevent ill health and save money. This report offers significant encouragement at a time when our NHS is witnessing increased demand for services.
“Combined with other results from across the country, we can see that the new models of care being tested and implemented by the 50 vanguards are making steady progress in reducing the pressure on GP and hospital services. These models are the foundations for transformation across health and care, including the sustainability and transformation plans (STPs).”
In conducting the evaluation, the Improvement Analytics Unit arranged for data to be linked between multiple sources, creating a novel database of the hospital admissions of care home residents. They then compared the health outcomes of 588 care home residents in 23 care homes in and around Rushcliffe between August 2014 and August 2016 with the outcomes experienced by 588 care home residents living elsewhere in the country (the ‘control’ group). The care home residents in the control group had not experienced an enhanced care package. However, in all other respects the two groups were carefully matched to ensure they were as similar as possible – including in terms of age, gender, ethnicity, socioeconomic deprivation, health conditions and the type of care home they lived in.
The enhanced care package was introduced by Principia in April 2014. In April 2015 they were chosen as a vanguard site for the NHS new care models programme.
