University of Hull evaluations of healthcare innovations are playing a key role in the NHS as it develops pioneering new approaches to tackling hospital admissions, particularly for the frail and elderly.
The evaluations, which supported conclusions in a recent BBC Panorama programme highlighting examples of new ways of working in the NHS, have been undertaken during a 3-year period – and are already informing new ways of working.
Academics from the University’s Faculty of Health Sciences have reviewed a series of services in our region, with their evaluations recognised in a recent Panorama episode: 'The NHS Crisis: Can It Be Fixed?' and broadcast on BBC One.
The episode shows how, pioneering approaches and innovations can reduce the number of patients admitted to hospital, prevent unnecessary attendances to A&E and support those who, if medically appropriate, can receive care in specialised healthcare centres in their home or care home.
BBC social editor, Alison Holt highlighted the innovative new Jean Bishop Integrated Care Centre in Hull, with services provided by City Health Care Partnership CIC, as a way to address frailty and healthcare issues, particularly in the elderly, as well as Oxford University Hospitals.
The programme focused on the critical state of the NHS – as hospitals are inundated and patients are facing increased waiting times. An ageing population living with more long-term health conditions is increasing the pressure on hospital departments. It highlighted the clinical model at the Jean Bishop centre, where patients come in for a full 'MOT' that looks at every aspect of their life and health to see where things can be changed to help them live happily and independently.
In the UK, there are nearly 3 million people who can be described as frail – about 4% of the population – and research suggests they require about 40% of all hospital beds and GP resources (Leston et al., 2022).
Dr Jacquie White, Interim Co-Head of School (Nursing and Midwifery) in the University’s Faculty of Health Sciences, said: “It was wonderful for the innovative approach to healthcare in Hull to be recognised in this way. The BBC explored the issues facing the frail and elderly in Hull – and gave a thorough insight into new approaches to patient care that are underway and could potentially be replicated in other parts of the country.
“To see the findings of our evaluations represented in the programme which shone a light on the pioneering healthcare developments in Hull was a highlight for us – as experience and expertise in clinical practice, academic roles and in health care commissioning and leadership.
“Our evaluations are the work of lecturers from the University’s Faculty of Health Sciences and it is extremely rewarding for us to see how it is helping to advance healthcare in our region and beyond.”
The evaluations were undertaken by Sally-Ann Spencer Grey, Lecturer in the School of Nursing and Midwifery, Jayne Walker, Senior Lecturer in the School of Advanced Practice, Joanne Hatfield, Lecturer in the School of Nursing and Midwifery. Their work which informed the BBC programme is below:
Sally- Ann Spencer Grey said: “Our evaluation of the integrated Care Centre Frailty Support Team Urgent Specialist Advice and Guidance phoneline is just one example showing how unnecessary attendances to the emergency departments and hospital admissions for individuals with frailty can be avoided. We were able to document a series of benefits, including the cost savings that resulted in 878 hospital admissions being avoided during the period.”
- Integrated Care Centre Frailty Support Team Urgent Specialist Advice and Guidance Telephone Line: This evaluation was undertaken to enable commissioners to consider the merit of retaining this service beyond the pandemic and the feasibility of its provision as a core service offer. The evaluation was funded by Ageing Well monies and the University of Hull was invited to undertake the evaluation by the East Riding of Yorkshire and Hull Clinical Commissioning Groups (CCGs). The high-quality care, clinical effectiveness, patient safety, increased utilisation and sound economic argument provide a convincing case for further investment.
- COVID Support Unit Specialist Advice and Guidance Telephone Line: This evaluation reviewed the service provided by the COVID Support Unit specialist advice and guidance telephone line prior to 13 July 2020. The COVID Support Unit service was provided during the height of the COVID-19 pandemic between 23 March 2020 and 10 July 2020. Contact with the telephone line resulted in 330 unnecessary hospital admissions being avoided suggesting improved quality of care experience for individuals and enabled more individuals to be cared for in their preferred place of care.
- Holderness Integrated Care Centre (HICC) Virtual Frailty Model Pilot: This evaluation showed that the care centre model proved to be effective, efficient, personalised, timely and safe and was acceptable to patients and staff. Patients enjoyed and were highly satisfied with their experience. They felt safe, said it was thorough, they were able to talk about what mattered to them, they felt valued, and appreciated the time and attention given to them. They appreciated not having to travel and attend a hospital-based clinic appointment. Staff felt it was a valuable service that gave great benefit to patients. Joint funded by the East Riding Clinical Commissioning Group and the University of Hull.
The team have also undertaken the following evaluations:
- Combined Acute – Community Trust Antibiotic Service: This evaluation reviewed an initiative developed between Hull University Teaching Hospitals NHS Trust (HUTH) and City Health Care Partnership CIC (CHCP). Specifically: Outpatient parenteral antimicrobial therapy (OPAT) which refers to administration of intravenous antimicrobial therapy on at least two separate days without an intervening hospitalisation. OPAT costs as a minimum 50% less than equivalent inpatient care realising significant financial savings. It avoids hospital admissions, reduces hospital bed days, has patient outcomes commensurate with inpatient care and patient safety equal to or improved (less hospital acquired infection risk) compared to inpatient care.
- Beanbag Care Services Pilot: This evaluation, which began in November 2022 and will report in January 2024, aims to provide evidence regarding the pilot achieving specific outcomes of interest to provide stakeholder groups, information for decision making about replication, upscaling or closing of the activities piloted. The findings can also be used to inform future policy. The findings will be presented as lessons/good practices and recommendations, any concerns/issues will also be identified. Funded by the East Riding of Yorkshire Council via the Better Care Fund (iBCF).
The NHS Crisis: Can It Be Fixed? can be watched on BBC iPlayer.