Welcome Registered charity no 252892 Scottish charity no

Welcome Registered charity no. 252892. Scottish charity no. SC 039245. The Clinical In-Reach Project Bev Piper, Clinical Lead Clinical In-Reach Project

Who are we? The Physical Health In-Reach Team consists of two Registered General Nurses Based within on a large Mental Health Hospital Site within the Later Life Unit Look after Long Term Physical Health Conditions to minimise transfer to the ‘acute’ trust Registered charity no. 252892. Scottish charity no. SC 039245.

Why are we here? The team was created in response to; • Safeguarding concern on one of the wards • Clinical Commissioning Group audit Registered charity no. 252892. Scottish charity no. SC 039245.

When did we start? The team commenced work on the Coppice unit 14 th March 2016 Registered charity no. 252892. Scottish charity no. SC 039245.

Key Performance Indicators (KPI) 1) Reduce avoidable admissions to acute mainstream hospital 2) Identify and reduce unavoidable A&E/Urgent Care contacts 3) Monitor District Nurse / OOHrs / GP / Primary Care contacts 4) Improve patient flow through care pathways 5) Improve mental health practitioners physical health knowledge, skills and competency 6) Support and improve discharge planning processes Registered charity no. 252892. Scottish charity no. SC 039245.

How have we done against the KPI? Reducing Transfers to the Acute Trusts: • Reduced avoidable Acute hospital admissions - Zero in the past 6 months • Reduced Acute hospital admissions by 66% • This has been achieved by undertaking 39 “prevention of hospital admission” visits Registered charity no. 252892. Scottish charity no. SC 039245.

How have we done against the KPI? Mental Health Practitioners L&D: • Four wound care study days across AWP (120 staff) • COPD and use of inhalers workshops at hospital base • Ward based microteaching sessions: pressure ulcers, catheter care, use of safety devices, hypoglycaemia • Opportunist 1: 1 teaching sessions Registered charity no. 252892. Scottish charity no. SC 039245.

How have we done against the KPI? Care Pathways: • • Wound Care End of Life Care Catheter Care Pressure Ulcer Prevention Registered charity no. 252892. Scottish charity no. SC 039245.

Challenges • Continue to monitor delayed discharges but limited inroads into this Reasons: • Lack of care packages available • Lack of specialist residential and nursing home placements Registered charity no. 252892. Scottish charity no. SC 039245.

Additional Benefits for AWP: • Work closely with AWP Physical Health Team • Help inform AWP polices, procedures and training • Support the adult wards (acute, PICU and rehabilitation) on the Bristol hospital sites • Supervise and assess trainees / pre-registered nurses practice Registered charity no. 252892. Scottish charity no. SC 039245.

Why does it work so well? • Team comprises of ‘general nurses’ with experience of managing Long Term Physical Conditions, Wounds and Catheterisation • Able to meet own CPD needs through the Community Trust Provider and the South West Physical Health Leads Group • We have successfully embedded ourselves within the team Registered charity no. 252892. Scottish charity no. SC 039245.

Where do we see this going? The team would like to see the pilot: • Increased to cover the whole BNSSG CCG at the Coppice (Bristol, North Somerset and South Gloucestershire) • Increased to cover the whole of Callington Road Hospital Site (eight wards) Registered charity no. 252892. Scottish charity no. SC 039245.

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