Clinical support

In all areas of West Sussex, GP practices are able to offer extra support to their care home patients. A number of different support packages are available dependent on location and to cover the period of the COVID-19 pandemic. 

Not all practices will have capacity to provide all of these services. Contact your local GP to see what is available.

Crawley, Horsham and Mid-Sussex areas

GPs can provide support to local care homes by reviewing new admissions and again after six months and also by visiting the home weekly.

Coastal West Sussex area

GPs can support care homes under the local Quality Improvement Scheme  with an assessment of new admissions and ongoing review every six months.

New arrangements for COVID-19

Extra support has been put in place for care homes. Each care home will have a named clinical lead they are able to contact and details of these will be sent out to care homes shortly. This clinical lead is not a direct patient-facing role but is the conduit for care homes to access health care support in a crisis.

GPs are now able to offer extra access to care home patients on weekends and bank holidays for telephone or video consultations. Additional support could include the following features:

• Direct telephone or video consult access to a GP or Advanced Nurse Practitioner (ANP).
• Care home teams to call GP/ANP before, and in preference to, calling 111/999 in the event of an urgent or emergency medical problem arising (unless the situation and care plan make 999 the most appropriate action).
• GP having remote access to patient records and be able to prescribe electronically (ePS).
• GP/ANPs to proactively call each care home, at an agreed time(s), at least once each day that they are covering.

GP/ANPs are not expected to do face-to-face assessment as part of the additional access.

The additional support can operate between 8am to 10pm, on weekends and bank holidays. Each practice or group of practices range of additional support will be determined by its capacity, so please contact your practice as hours may vary.

This additional support is temporary, for the period of the COVID-19 pandemic. Practices will continue to provide their usual support to care homes during regular operating hours.

Practices are also able to offer support to residents of care homes who are resident on a temporary basis, for example in step down beds. Under this scheme, residents will be registered as temporary residents of the practice.

Recent national guidance has stated that support for care homes at this time should include a weekly check-in and support to develop personalised care plans. This could be under one of the schemes listed above, but where these are not available, alternative arrangements will be put in place. Confirmation of these arrangements will be available shortly.

Sussex Community NHS Foundation Trust provide community nursing support to the county’s care homes, as follows.

Crawley, Horsham and Mid-Sussex areas

Care homes can contact the Care Homes Support Team (previously the Integrated Response Team). This is a multi-disciplinary team, including a dietitian.

The team has a rolling training programme in place that all care home providers are eligible to book onto and it can also provide bespoke support to care homes, when required.

The team can be contacted via email at SC-TR.CareHomes-North@nhs.net or by phone on 01293 301009. 

Coastal West Sussex areas

Local care homes are supported by the Admission Avoidance Matrons (AAMs). The AAMs sit within the Rapid Assessment and Intervention Team and are focused on reducing avoidable hospital admissions. They primarily work closely with care homes and care homes with nursing to support patients with deteriorating health who can’t be managed safely within the available resources of the home.

AAMs provide expert support to improve care planning and delivery and also liaise with other appropriate support services, including primary care, to ensure there is a coordinated plan in place. As well as dealing with patients in an acute episode, AAMs also work proactively with homes to provide training and information to help improve patient care and reduce the incidence of acute episodes.

AAMs will respond to requests for support but also contact homes periodically to promote the service and build relationships.

The AAMs can be contacted by phone via OneCall on 01903 254789.

Starline

All CQC-registered care homes can now sign up to gain access to the new urgent community care support service. Starline gives fast access to a range of clinical care professionals for urgent advice, via NHS 111 and dialling *6.

Starline provides a formal support line for care professionals and domiciliary workers on scene with a patient in a care home. It gives access to rapid clinical advice and rapid response services in your area through direct conversations with GP’s; mental health nurses; dental nurses; pharmacists; registered general nurses; advanced nurse practitioners; and paramedics.

The teams can directly support you to care for your resident, without the need to transfer them to another service for treatment (if appropriate to the clinical need), improving patient safety and experience for the frail and elderly.

Starline, which is part of the NHS 111 CAS, is not intended to replace existing urgent support services such as Health and Social Care Connect in Brighton and Hove; One Call One Team in West Sussex; or The Professional Support Line (PSL) for East Sussex, but works alongside to provide an escalation point for urgent community support when you need it. The service can also escalate to 999 if required.

Care homes are invited to complete the memorandum of understanding (MOU) to gain access to Starline. The collaborative agreement sets out the responsibilities of the NHS 111 Clinical Assessment Service (CAS) and care homes. Completed MOUs can be sent to dawn.fourniss@nhs.net for processing.

For any questions about the service or the MOU, please contact:

• Dawn Fourniss, Business Support Manager, Sussex NHS Commissioners dawn.fourniss@nhs.net
• Colin Simmons, Programme Director, Sussex NHS Commissioners colinsimmons@nhs.net

West Sussex NHS Clinical Commissioning Group's IPC team provides advice and support to care homes and can be contacted via sxccg.infectionprevention@nhs.net for any queries around use of PPE or infection prevention and control issues.

The team is also contacting homes which may need support, including those which have had an outbreak of COVID-19.

This guidance has been jointly developed with commissioners and providers for Sussex wide usage and highlights when to call 111, 999,  your resident's GP or other community services.

The advice also covers when it is felt appropriate for staff to seek to support a person to get up from the floor following a fall - this is especially important with COVID-19, to be supporting our residents to keep them safe and prevent admission to acute hospitals where possible.

Following a fall, if the person is unable to self-mobilise, staff should use the appropriate lifting equipment if available, and only if staff have been trained to use it.

In the absence of equipment or other support available, please check the Additional Area Guidance at the bottom of the flowchart, an ambulance will need to be called and the person kept comfortable on the floor with blankets and pillows.

For any questions or support regarding this document please contact the Care Homes equipment mailbox: sxccg.carehomesequipment@nhs.net 

Please note the linked document (Advice on seeking urgent and emergency care from SECAmb)  might not be suitable for users with assistive technology. If you need this information in another format, please contact aopcontracts@westsussex.gov.uk

The British Lung Foundation and Asthma UK have set up a post- COVID hub to bring together information about the longer-term impact of COVID-19.

It includes a helpline for offering support to patients with post COVID-19 breathlessness and could be helpful if you are supporting people who have recovered, or are recovering, from COVID-19.

The helpline is available Monday to Friday 9am – 5pm on  0300 222 5942. 

The Learning Disabilities Health Facilitation Team

 A team of nurses specialising in facilitating health care for people with a learning disability age 14+. This includes an acute liaison service for people with learning disabilities  when they are admitted to hospital or attend as an outpatient. During COVID-19 this is a 7 day a week service.

The team can be contacted by phone on 01403 227 000 ext. 7341.

Hospital Passports

Hospital passports for people with learning disabilities are designed to communicate a person’s needs to doctors, nurses and any other healthcare professionals.  A health passport  for autistic people is also available to download from the National Autistic Society website.  It is important to include all relevant information in the passport so that it can be used quickly in an emergency.

NHS 111 Easy Read leaflet

There is a new NHS 111 easy read leaflet with accessible information about how to use the service, designed for people with a learning disability and for people who are autistic. It reminds people of their rights to reasonable adjustments.

Sussex Mental Healthline offers crisis care for people with significant and escalating mental health concerns.

The Healthline operates 24 hours a day, seven days a week and is available to people of all ages and their carers.

Phone: 0300 5000 101

Profiling, adjustable or medical beds (beds) are used extensively in hospitals, care homes and people’s own homes. It is essential that these beds and associated equipment are used correctly and safely to minimize the risk of injury or death to bed occupants.

The Medicines and Healthcare products Regulatory Agency (MHRA) continue to receive reports of adverse incidents involving beds and equipment, the most serious leading to injury and death.

The list of guidance below, published by the MHRA, sets out good practice aimed at anyone with responsibility for the provision, prescription, use, maintenance, and fitting of beds and associated equipment. This includes the importance of appropriate staff training, correctly following manufacturers' instructions and adequate service and maintenance of beds and equipment.

• MHRA NPSA (relating to beds and equipment)
• MHRA bedrails guidance
• MHRA medical device guidance

It may not be immediately obvious to consider a bed as a medical device and it is worth noting that, although the medical device guidance doesn’t list profiling/adjustable beds as a medical device, the above medical device checklist does.