1. ITHAcA: Integration to avoid hospital admission – new directions June 12 th 2015 Helen Baxter on behalf of ITHAcA

2.  Sarah Purdy (lead director) University of Bristol  Jonathan Benger U.W.E and UHB  Peter Brindle APCRC  Helen England BrisDoc  James Calvert NBT  Alison Comley Bristol City Council  Peter Goyder Bristol CCG The directors

3.  To reduce avoidable hospital admissions across BNSSG Purpose Integration to avoid hospital admission Areas of focus  COPD, childhood respiratory, dementia and using data to inform commissioning

4. COPD: Childhood respiratory:  PhD project on childhood respiratory admissions and decision making by parents and professionals in the ED  Mapping local asthma services to model patient flows APCRC 2014 Research  To evaluate admission/discharge care bundles for COPD patients. NIHR HS&DR 2014  Study of using systems dynamics modelling for COPD services. APCRC 2013

5. Dementia:  An exploration of the available data to understand better the causes for admission. CLAHRC West 2014  A systematic review of the literature to develop an appropriate intervention for this population. CLAHRC West 2014 Wider scope:  Programme development grant around managing risk to reduce emergency bed days for older patients. NIHR 2014

6. Avoidable hospital admissions (patient groups of focus - childhood respiratory, dementia & COPD) The management of risk (primary and secondary care) Data to inform commissioning

7. Research Implementation Unanswered questions CCGs and providers

8.  Discussion Working Groups (DWGs) Virtual Wards Feb 2014 and Avoiding Unplanned Admissions Enhanced Service July 2014  Presentations The Urgent Care Review by Jonathan Benger, 2014, An Acute Frailty Service by Dan Lasserson, 2015  Information repository What are we already doing?:

9. Avoidable hospital admissions (patient groups of focus - childhood respiratory, dementia & COPD) The management of risk (primary and secondary care) Data to inform commissioning Influence & engagement (DWGs and presentations) Information repository Patient and public involvement

10. Can we do more?:  Researcher in Residence focusing on Urgent Care  The unanswered questions  Co-produced projects  Discharge of patients from secondary care – risk management and clinical decision making. APCRC & CLAHRC West  Out of Hours abnormal tests results. APCRC

11. The future:  Implementation of the findings from the projects by working with the CCGs and service providers  Using these relationships to gain feedback to inform the next questions for research. Networking and linkage with CCGs and service providers

12. Avoidable hospital admissions (groups of focus - childhood respiratory, dementia & COPD) The management of risk (primary and secondary care) Data to inform commissioning Influence & engagement (DWGs and presentations) Information repository Patient and public involvement Networking and linkage with CCGs and service providers