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Dudley CCG NHS fallback


Service to cut A&E visits from “frequent callers” in the Black Country a Success

07 Nov 2019by lindseyh

Vulnerable patients are benefitting from a new frequent user project across the Black Country and West Birmingham.


A one-year evaluation of the project commissioned by Dudley CCG and Dudley CVS has shown that in those patients who frequently attend A&E, there was a 33% reduction in attendances and a 41% reduction in inpatient admissions, saving the NHS more than £500,000.


Delivered by the Dudley CVS Integrated Plus social prescribing team and match-funded by Dudley CCG and the Department of Health, the service offers a robust way of reducing avoidable frequent user activity to 999, NHS 111, A&E, and hospital admissions, freeing up front line resources to improve care for all patients and reduce costs.


Working together with partners, the High Intensity User (HIU) team uses a flexible and innovative non-clinical approach, to target high users of services and support the most vulnerable people within the community to flourish and find purpose in their lives.


This is in line with the Right Care Programme, which is part of the NHS Long Term Plan’s focus to better understand the needs of patients who are frequent users of emergency departments. Both will work to improve waiting times and response in emergency departments for those patients with the highest care needs is a priority.


Kelly Rea, (Urgent Care Link Worker), HIU Team said: “It all starts with a phone call, from which I am able to actively listen to understand the needs of those patients who are accessing A&E departments on a regular basis. I like to arrange a face-to-face appointment as soon as possible to gain a better understanding of their situation. On the first visit, I try my best to make it very relaxed to allow them to tell their story.


A local service user said, “This service, in my opinion, is vital to help other people from utter despair, I cannot explain in words what this service has done for me.


“After another attempt to end it all, I was given a lifeline, introduced to my link worker from Integrated Plus, always at the end of the phone, caring and understanding, non-judgmental who listens to my every need in my recovery. My link worker takes me out for coffee and shopping and has enabled me to laugh again and understand a future without pain. I look forward to her visits helping me to feel normal again”.


Kate Green, Deputy Chief Executive of Dudley CVS, explained: “We had one lady who had attended A&E 52 times over a period of 12 months with a range of issues, all of a social nature. After visiting her and exploring the nature of her calls and attendances, we found she was feeling worried and anxious about family issues, in particular her son. She expressed she had nobody to turn to about how she was feeling and felt if she went into hospital or spoke to paramedics, they would have the answers, but this was never the case.


“Since getting involved, we have helped her to engage with a number of services and ensured she has the support relevant to her needs. She no longer attends A&E or contacts 999 when she has questions or is worried about something. She writes these down in her diary and takes them along to her support group where she feels she gets the right support and has made new friends.”


Jonathan Fellows, Chair of Black Country and West Birmingham STP, said: “We are really happy that the service is benefiting people in the Black Country and West Birmingham. The High Intensity User Service is an example of partners working collaboratively to reduce pressures on A&E by making sure patients are seen by the right person in the right place.”

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