An example of integrated care – my visit to ORCAT

We hear a lot about health services changing to become more ‘integrated’. Put simply, this means working closely together so the care patients receive is more joined up.

At Pennine Care, we are working with partner organisations across our footprint to integrate more services and improve patient experience. I recently visited the ORCAT service – a perfect example of this.

ORCAT (or Oldham Rapid Community Assessment Team) was set up by the Oldham Urgent Care Alliance. Pennine Care is a key member of the alliance, which is a partnership of 10 health, care and voluntary sector organisations developed to improve outcomes for local people by enhancing current services.

ORCAT works closely with colleagues at The Royal Oldham Hospital, including those in the A&E department, to react quickly and prevent people from being admitted to hospital if they can be supported at home with the right professional help. Once at home, the team takes a partnership approach to assessment and care planning to understand what level of support the individual may need to live as safely and independently as possible.

It consists of therapists, nurses, health care assistants and mental health practitioners from Pennine Care NHS Foundation Trust, social workers from Oldham Council, and a Promoting Independence in People (PIP) support worker from Age UK Oldham, who have been brought together to work as one multi-agency team.

As well as preventing people from being admitted to hospital by identifying them early, the team works closely with hospital-based nurses, doctors, discharge coordinators and the RAID mental health liaison team to also support patients who have been admitted to the wards who could be discharged early with the support of the service. 

I met with three members of the team - Cathy, Rachel and Claire – as many others were out and about supporting people at the hospital or in their homes.

It was a really good afternoon; we talked through the service model which was brought to life by patient stories that illustrated the support not only for the patient but for families and carers as well.

Everyone talked about how great the ‘team’ feel was and the fact that each member’s contribution was of equal value to the end outcome. The team really valued the input of the Age UK PIP worker, which makes a huge difference to the team’s success.

The team has worked very hard to build relationships with colleagues in the local hospital and over the past few months things have really moved on in terms of embedding the service.  However, they acknowledged there is still some way to go with raising profile for GPs, so that they understand the potential for people to be supported at home by the team. The GPs who they do work with are really impressed with the support the team is able to mobilise at pace and the range of issues that they are equipped to deal with. 

There were, of course, a few frustrations felt by the team – these were mostly around the type of things that can add delay to discharges. Overall, it was lovely to hear that all three staff were enthusiastic, energetic and said they really enjoyed their job and went home knowing that they’d made a real difference to someone’s life.

While I was there, I noticed a compliment that had been sent in by a relative. With the team’s permission, I wanted to include a snippet of it in this blog as I think it really demonstrates how the team can support people:

“Immediate support following discharge from hospital of my 94 year old father… ORCAT is a fantastic service and were a lifeline to our family. All the ORCAT workers who supported my father combined efficiency and knowledge of care for the elderly with kindness, patience and encouragement. They were excellent. The service is well coordinated, ensuring effective care was in place from day 1 after discharge. This is the health service at its best. *Gold Star*”

I went away feeling really upbeat and very impressed with the dedication and values that shone through the staff I spoke with. Thanks to Claire, Cathy and Rachel for meeting with me.

Judith Crosby

Executive Director of Service Development and Sustainability

Leading by example

My latest blog is helped by the Chief Operating Officer at Oldham Clinical Commissioning Group, Denis Gizzi.

Denis doesn’t blog, many say he should, but he does offer great leadership insights.  I was lucky enough to be copied into a note he sent to his staff one Friday afternoon recently.  It neatly described how the CCG had worked with our community services to respond to a family’s concerns about the care provided to their relative. 

It was really well received and I asked him if he’d have any objections to me sharing it. I will let his words speak for themselves, please read below:

“Dear colleagues,

It's been a strange week, but I thought I'd do something I've not done before (and probably won't make a habit of), which is to share a couple of thoughts at the end of a busy week.

You've all heard my mantra on 'time to value' over the last 12 months and I know there is a healthy slice of polite acknowledgement.  Here is a local patient example I’d like to share: 

The family contacts me directly as they are worried and concerned about the lack of care co-ordination following the hospital discharge of a 94 year old gentleman with many co-morbidities.

The CCG team reacts. Clinical advice is sought. Community clinicians are engaged. Mistakes are corrected. Care co-ordination is put in place. The family are understandably anxious. Full assessment and care package in place within a few days.

The family contacts me again.  State 'we had no idea what a CCG was, we now know, the CCG has saved my father’s life.   This may be a little exaggerated, who knows.  What really matters is that 'time to value' has been demonstrated, it is real, it touches people’s lives, and it works because people care about bringing a resolution to an individual's problems as quickly as possible. Time to value? Yes it is very important.

I'm not going to pick out individuals for praise, it's a team effort. Some of these problems were resolved out of standard hours. It is noted and greatly appreciated.

So you see, it's not management mumbo-jumbo, it's what our public expect from us. They want us to make good decisions, act on them, and make change happen quickly. We are getting better at it, but clearly we need to do more.”

I just thought it was a great example of how leaders can show a commitment to staying true to what the public want to see in how we lead their NHS.