1. OUT OF HOSPITAL LOWESTOFT Debbie Coe Jason Peek

2. What Do We Do? Rapid Response Crisis Intervention Keep people at home Access to beds with care Facilitated early discharge

3. Staffing Trained Nurses Therapists Social Workers Assistant Practitioners Triage Rehab Support Workers Admin

4. Referrals and Assessments ECCA – single point access Triage Allocation Assessment Plan of care 4

5. Dementia & UTI Urgent AX from GP Carer overnight Reablement at home Less confused in normal home Recovery & back to normal function 5 days

6. Before - Taken to her bed Malnourished Dehydrated Not taking medication Dog and human faeces Joint Assessment within 2 hours of referral After – 2 weeks later Medically stable Managing medication Self caring – x1 daily carer Attendance allowance Safe and clean home

7. Patient Choice Advanced cancer Discussed EoL plan and choices Chose bed with care Remained at home as long as possible Died with family around her

8. Bed with Care Call from paramedic Patient on floor 24hrs Infected leg ulcers No mobility Admitted Blyford Medical assessment Reablement plan Functional OT Discharged home 10/7 with OHT reablement HCP Independent by 3/52

9. Local Residential Home goes into crisis Response within 6 hours Carers sent in to care for residents Social Services assessment on all residents Medical assessment on all residents Care continued for 2 weeks All residents safe and no need to shut home