1. CCG Delivery Day HomeFirst Update
Chris Badger
Assistant Director for Health and Social Care Integration

2. Lower Lea Valley HomeFirst Update

4. Referrals into HomeFirst – Weighted rate per 1000 population compared with emergency admission rate (ages 65+)
Some practices are referring almost half what Warden Lodge and Maples is referring based on weighted population.
Doesn’t seem to be any correlation between referral rate and admission rate.

5. Virtual Ward 96.5% of referrals seen within 1 hour
Virtual Ward Statistics
Nov-12 to Apr-14
May-14
Jun-14
Jul-14
Aug-14
Sep-14
Oct-14
Nov-14
TOTAL
Case Management
Admissions
983 71 56 53 41 66
1392
Discharges
879 43 78 46 61 63
1269
On Ward at Month End
104
132
135
113
120
100
123
Average Length of Stay
44.6
47.1
43.2
52.5
72.9
66.0
47.0
49.0
Rapid Response
426 24 30 21 32 23
601
416 31 27 22 26
596 10 3 12 9 8 6 5
14.3
9.1
14.8
9.4
8.8
8.3
12.1
12.9
Occupied Beds at Month End
118
147
122
128
106
96.5% of referrals seen within 1 hour

6. Impact on secondary care

7. Impact on secondary Care – A&E Lower Lea Valley initial pilot monitoring based on projected levels
Projected levels using a decomposition method to take into account both trending and seasonal patterns via MedeAnalytics. This applies to all projections used in the following charts.

8. Impact on secondary Care – A&E Lower Lea Valley initial pilot monitoring based on projected levels

9. Impact on secondary Care - Emergency admissions Lower Lea Valley initial pilot monitoring based on projected levels

10. Impact on secondary Care - Emergency admissions Lower Lea Valley initial pilot monitoring based on projected levels

11. Impact on secondary Care - Emergency admissions Activity pre and post Homefirst (12 months)

12. 2% reduction in ambulance conveyances
Impact on secondary Care Change in the % of ambulance conveyances post Homefirst commencing
2% reduction in ambulance conveyances
Useful or delete?

13. No change in % of ambulance conveyances to total A&E
Impact on secondary Care Change in the % of ambulance conveyances post Homefirst commencing
No change in % of ambulance conveyances to total A&E
Useful or delete?

14. Impact on secondary Care – A&E Lower Lea Valley monitoring based on statistical process control (SPC)

15. Impact on secondary Care – A&E comparison with other localities, monitoring based on statistical process control (SPC)

16. Impact on secondary Care - Emergency admissions Lower Lea Valley monitoring based on statistical process control (SPC)

17. Impact on secondary Care - Emergency admissions comparison with other localities, monitoring based on statistical process control

18. Quality

19. 83%
(HCT overall 77%)

20. 96.36%
Harm free care

21. North Herts HomeFirst Update

24. Referrals into Homefirst – Weighted rate per 1000 population compared with emergency admission rate (ages 65+)

25. Virtual Ward 96.5% of referrals seen within 1 hour
VIRTUAL WARD STATISTICS
Jul-14 to Aug-14
Sep-14
Oct-14
Nov-14
TOTAL
Case Management
Admissions 70 72 97 66
376
Discharges 34 64 83
318
On Ward at Month End
107
115
129
Average Length of Stay
50.5
47.9
39.0
41.0
43.4
Rapid Response 50 73 63 45
302 41 59 40
283 24 38 29
9.8
12.3
9.4
12.8
10.9
Supported Discharge 26 33 39 31
200 22 32
192 7 11 12
7.1
9.0
6.5
7.4
Whole Service
Occupied Bed Days
5871
4046
4791
4659
19367
Occupied Beds at Month End
138
164
170
174
96.5% of referrals seen within 1 hour

26. Impact on secondary care

27. Impact on secondary Care - Emergency admissions North Herts year on year weighted rate per 1000 population

28. Impact on secondary Care – A&E North Herts monitoring based on projected levels

29. Impact on secondary Care – Emergency Admissions North Herts monitoring based on projected levels

30. Supported Discharge

31. DISCHARGES FROM SUPPORTED DISCHARGE BROKEN DOWN BY DISCHARGE DESTINATION
Lavender
Rose
Total
%age
Care Complete 5 8 13
10.7%
Case Management 36 20 56
46.3%
Core Team 6 18 24
19.8%
Hospital 10
8.3%
ICT Bed 3
2.5%
Nursing Home 2
1.7%
No Destination 4 9
TOTAL 65
121
100.0%
Supported Discharge
Jul-14 to Aug-14
Sep-14
Oct-14
Nov-14
TOTAL
Average Length of Stay
7.1
9.0
6.5
7.4

32. Quality

33. (includes whole locality)
80%
Trying to see if we can extrapolate the HF data from the localtty data.
(includes whole locality)

34. 93.44%
Harm free care

35. Next steps
Promotion across practices Care Homes Mental health integration Health psychologists and self-management Supported discharge audit