Improving care for deteriorating patients in the community

A significant number of individuals with complex needs receive care in the community: at home, in care homes or in specialised supported accommodation (for people with learning disabilities).

Their ongoing care is delivered mostly by non-clinically trained care staff who do not always have the confidence and competence to recognise physical deterioration in people they care for. This can result in inappropriate escalation and unnecessary hospital admissions.

To improve the experience and outcomes for this group of people, we are running a programme to train and support non-clinically trained staff to recognise, escalate and communicate the early signs of deterioration in a timely and appropriate fashion.

We will work with organisations that commission and/or provide community health and social care services from across the UCLPartners region, to test and implement two innovative approaches:

  • the Significant 7+ training and toolkit to detect the soft signs of deterioration, helping staff to assess the situation and escalate appropriately.
  • the Whzan digital telehealth solution to undertake clinical observations, calculate a NEWS2 score and respond quickly through appropriate escalation routes.

We are looking to test these interventions in:

  • home care with domiciliary care providers
  • residential and/or nursing care homes
  • community nursing
  • reablement teams
  • specialised supported accommodation for people with a learning disability.

During the programme we will be working with:

  • North London Partners Health and Care STP
  • London Borough of Newham
  • East London NHS Foundation Trust
  • Castle Point and Rochford and Southend CCG

Teams testing Whzan will receive free portable monitoring kit(s) and a 6-monhtly subscription with ongoing support to implement the solution. Those opting for Significant 7+ will benefit from being part of the Train the trainer cohort with annual licence fee covered by UCLPartners and ongoing support to introduce and sustain the intervention.

If you would like to know more about this work, please email Valentina Karas, Patient Safety Programme Manager, at