Improving services for older people
To improve services for older people we are working together with Southwark CCG and the hospitals and health providers across the area. This new way of working is called the Lambeth and Southwark Integrated Care Programme and is funded by the Guy's and St Thomas' Charity.
Treating older people at GP practices and in their own home
We know that many older people would rather be at home than in hospital. For this reason we want to make health services which are normally only available in hospital available where people live. For example nursing support and support for people to be discharged from hospital sooner.
We are also improving urgent care access for older people in crisis. GPs have access to a Geriatrician for advice and support 24 hours a day 7 days a week so they don't have to send all older adults in crisis to hospital to be seen by the Geriatrician. We have found over the last year this service has been successful.
More joined up health services
Different health services can now share clinical documentation quickly and easily. All the doctors and nurses involved in an older persons care can make decisions together, even if they are located in different places, this means people get the best possible care.
For example local hospitals and mental health providers can now securely send clinical documentation directly into the GP system, for example information about an older person's discharge from hospital, without relying on an e-mail or fax.
Improving dementia services
One of the key types of care we are looking at joining up are those for people who have dementia. It is important to make sure the pathway through services is clear for people with dementia, their carers and families. To do this the NHS, social services and the voluntary sector must all be aligned and we are working closely together to make this happen.
Support to avoid falls
Helping older people avoid falls has been a priority of ours for many years and the service provided in Lambeth have been successful. In addition, we will be offering new 'Community Strength and Balance' classes to older people who are at risk of falling.
Providing healthy diet advice
We also want to support older people to lead a healthy lifestyle so they don't get ill and have to go to hospital. If older people don't eat well this can have a big effect on their health. We will be commissioning a community dietetic service, which means older people will be able to talk to a health professional for nutrition advice.
Avoiding and treating infections
We are also working to reduce avoidable infections. We are testing the use of 'catheter passports' to accompany people on discharge from hospital to ensure that GP and pharmacy services, community services and nursing homes have this information to better manage catheters and reduce the likelihood of infections; a similar approach is being taken with urinary tract infections and cellulitis in the community.