1. Holistic Assessment Rapid Investigation
HARI
Holistic Assessment
Rapid Investigation

2. HARI Definition
A multidisciplinary community service for adults with complex medical and rehabilitation needs

4. HARI Vision Keeping people well Prevent unplanned hospital admissions
Reduce the risk of falls
Enable independent living
Rehabilitation  

5. Referral Criteria Patients: registered with a Merton GP
aged 18 years +
requiring therapeutic intervention from more than one health professional including: Consultant Physician; Advanced Nurse Practitioners; occupational therapists; and physiotherapists. Pharmacist – coming soon!
with mental capacity to participate in group and individual based rehabilitation
Complete single referral form SMCS website – tick “HARI”or “rehabilitation”
Provide information to outline anticipated patient outcomes and choose an appointment with an appropriate health professional if known
Transport can be offered for those unable to travel independently

6. HARI Referrals The referrer can select a choice of 2 service options:-
A full assessment by the whole team including a full Consultant/ANP assessment, plus therapy assessment, falls screening and rehabilitation.
For this pathway, referrals can only be made by the GP
2. For those requiring rehabilitation only, referrals can be made by GPs but also directly from SMCS rehab teams e.g. Rapid Response, Falls Prevention Service and also, if appropriate, patients with Parkinson’s Disease will automatically be reviewed on a 4 – 6 monthly basis team
Patients will be offered a routine appointment within 10 working days

7. Meet the HARI team Consultants Physicians Advanced Nurse Practitioners
Nurses
Health Care Assistant
Occupational Therapists
Physiotherapists
Rehabilitation Assistants
Administrators
Pharmacist – coming soon
Podiatry – Regular sessions

8. Assessment and Investigation
The team will provide assessments, request investigations and formulate management/ care plans
Holistic – reviewing patients, carers and their needs
With Advanced Nurse Practitioners, consultants, physiotherapists and occupational therapists
Investigations, as required, can be organised during the initial visit or with subsequent visits

9. HARI Rehabilitation Based at the Nelson Health Care Centre
Assessments are carried out at the Nelson and therapists also assess in patients’ homes.
Patients have the option of a morning or afternoon session
On arrival patients are offered a hot drink and have their nursing observations before commencing therapy
AM therapy sessions start from 9.30 – 11.30
PM therapy sessions start from – 15.30

10. Rehabilitation: Occupational Therapy
Full Occupational Therapy Assessment – seeking to promote independence at home and within the community.
Home Assessments to assess an individual’s functional ability within the home to assess for home hazards and reduce the risk of falls.
Prescription of specialist equipment to promote independence
Wheelchair assessments and practice
Moving and Handling Risk Assessments
Upper limb and Hand Assessments and hand rehabilitation
Orthotic Fabrication
Cognitive Assessment
Anxiety Management Training, psychological support and the promotion of wellbeing and healthy lifestyle choices
Health Promotion and advice for patients and carers

11. Rehabilitation: Physiotherapy
Full Physiotherapy assessment including balance, strength, mobility and falls assessment.
Gait assessment and re-education including
outdoor mobility practice
Provision and review of walking aids
Individual and group exercise within gym environment
Home assessments to review mobility
Home exercise programme
Onwards referrals to Falls Prevention Service and Community Support Services

12. Falls Service Provision
Three key teams provide the SMCS Falls Service
Holistic Assessment & Rapid Investigation (HARI)
CRISIS/Community Rehabilitation Team
Falls Prevention Service (FPS)
PLUS
Other Falls Pathway Teams
Community Neuro-Therapy Team (CNTT)
Rapid Response Team (RRT)
Community nursing

13. External Collaboration
HARI
Secondary Care-Specialist Teams
Mental Health
General Practice/
Primary Care staff
Dementia Hub
Social Services
The Voluntary Sector

14. Internal Collaboration
HARI
Community Rehabilitation Team
Community Nursing Teams
Community Prevention of Admission Team
Continence Service
Speech and Language Therapists
Falls Service

15. Patient Example

16. Future Innovations
New HARI pharmacist to support medicines optimization
Improve links with Mental Health Services including links with new Dementia Nurses
Currently recruiting 2 new Occupational Therapists to link in with the above and 1 new Physiotherapist.

18. Contact details Referral Queries- Adult Referral Centre HARI Queries –
HARI – Holistic Assessment Rapid Investigation
Contact details
Referral Queries-
Adult Referral Centre
Sutton and Merton Community Services Administration Centre
Tel:
HARI Queries –
to speak to a clinician
HARI
Nelson Health Centre
Kingston Road
Raynes Park
London SW20 8DB
Tel: