The hospital avoidance response team – HART – service is delivered by members of the Lincolnshire Independent Living Partnership and takes referrals from secondary care discharge hubs, A&E in-reach teams, the ambulance service, primary care and community health providers. This example of a local initiative forms part of our managing transfers of care resource.
Eligibility extends to people over the age of 18 who live in Lincolnshire and for whom support would either prevent an avoidable A&E attendance or admission, or speed up discharge from secondary care. This is achieved through:
- facilitating a supported discharge and providing up to 72 hours of care and support to resettle a person at home
- offering a ‘bridging the gap service’ for a 72-hour period to give other domiciliary or reablement services the opportunity to commence later in the pathway
- supporting the clinical assessment service to avoid hospital admission and/or attendance at A&E
- offering a telecare unit, enabling access to the responders 24/7 – with the assurance of support through the night if required
- offering a wellbeing service assessment with onward referral as appropriate.
The service is currently accepting a little over 100 referrals per month, with 1,553 people supported between December 2015 and August 2017.
During this period, 303 admissions were avoided, a proven 1,220 bed days were saved, and a further 670 days were potentially saved. Assuming an admission cost of £2,000 per admission, and £400 per bed per day, the service has achieved an indicative saving of between £1,094,000 and £1,362,000.
CEO Age UK Lincoln and Kesteven