A specialist frailty service developed by Cambridge University Hospitals NHS Foundation Trust has reduced hospital admissions for care home residents by almost a quarter (23 per cent) and cut the average length of hospital stay by just under a third (32 per cent), according to research published in Age and Ageing.
The Enhanced Reviews in Care Homes (EnRICH) service, delivered by hospital geriatricians working alongside care home staff, GPs, community nurses and pharmacists, was established to support older people with frailty and multiple long-term conditions in their care homes rather than in hospital.
An evaluation across 11 care homes in Cambridgeshire over just over a year analysed more than 6,000 emergency department attendances. It found hospital admissions fell by almost a quarter following the introduction of the service, while residents who were admitted spent nearly three fewer days in hospital on average.
The trust said the reductions equate to around 1,300 inpatient bed days saved each year and an estimated annual saving of £700,000.
Care closer to home
Researchers said the findings support the wider NHS policy shift towards delivering more care in community settings. The Government’s 10 Year Health Plan for England and NHS England’s frailty pathway guidance both identify people living with frailty as a priority group and emphasise moving care and resources from hospitals into community-based services.
The service provides regular assessments, rapid clinical support when residents become unwell and continuity of care if admission to Addenbrooke’s Hospital is required.
Cambridge University Hospitals NHS Foundation Trust consultant geriatrician Dr Matthew Butler (pictured, left) said: “This innovative service improves the quality of care for some of our frailest patients, enabling them to access specialist support without leaving the familiar surroundings of their care home”, adding the initiative “takes a proactive, preventative approach, helping residents before they get to hospital.”
Heathlands House care home manager Razvan Stanbeca (pictured, right) said the service had “enhanced the care we provide”, adding that staff felt “more confident and more empowered to provide even better care for residents”.
Following the evaluation, EnRICH has expanded to 15 care homes in Cambridgeshire with the highest levels of hospital admissions, funded by NHS Central East Integrated Care Board.
