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The perfect week
The Perfect Care Week is a national improvement programme from the Department of Health (DoH), allowing a growing number of trusts across England to implement changes that can improve the way patients move through the NHS system. The programme is also designed to better understand why there can be delays in care, and make lasting change. The main purpose of the week is for various organisations across the health sector to work together and concentrate efforts on ensuring patients flow through the health system in the safest and most efficient way possible.
During the week, 'safer in care' principles are implemented and aimed at making sure patients get home from hospital, with the support and care they need, as soon as they are medically fit to be discharged from acute hospitals, A&E and hospital wards or the community equivalent. The Perfect Care Week is an opportunity for health organisations to work differently, with the aim of easing pressure on health and social care , particularly urgent care.
The Self Care Forum – My Health, My Life
As a foundation to all of this the Self Care Forum was established in May 2011 with the specific aim to further the reach of self care and embed it into everyday life. Forum members include patients, GPs, nurses, pharmacists, health service managers, and of course the Department of Health. Personal engagement is a key aspect of the Five Year Forward View. Achieving engagement is the focus of the Self Care Manifesto which highlights four pillars of engagement:
- Lifelong learning – Provide education and personal resources at every stage of life to encourage self care and empowerment.
- Empowerment – Promote the use of health and care services as a way of supporting personal and home care decisions, blurring the lines between patient and professional.
- Information – Provide reliable, consistent information, evidence-based where possible, to support confident decision making.
- Local and national campaigns – Use national and local campaigns to focus on a rolling programme of education with consistent messages, such as the Perfect Care Week.
National and local campaigns, including public health, will focus on a rolling programme of education with consistent messages. Short, positive, consistent messages are developed and given to people attending A&E, GP practices and pharmacies for self-limiting conditions, to break the cycle of dependency and empower patients to be their own medical expert with support from their clinicians when they need it. Education, good information and national campaigns to encourage confidence in self care are required to build on the success of public health programmes such as stopping smoking and reducing antibiotic use.
Local public health messages should also reach beyond national campaigns to cover local and targeted wellbeing and health issues. Here in Lincolnshire we are currently being supported by the national Emergency Care Improvement Team, and have been taking part in an exercise aimed at ensuring patients are able to return home as soon as they are well enough to be discharged.
What happens during Perfect Care Week?
Before Christmas some hospitals found themselves in difficult circumstances including high use of A&E services and increased admissions, and we know that overcrowded hospitals often lead to poor patient outcomes and experiences. These situations can lead to NHS organisations implementing initiatives to improve services using the Perfect Care Week model. Although this needs commitment and resources the outcomes can significantly improve patient outcomes and identify efficiencies as well as inefficiencies in the current system including increasing awareness, engagement and prevention of safety incidents.
Although most of us would expect this care to be in place already, some examples of what may be implemented in hospitals during the Perfect Care Week include:
- Focused time from nursing teams and specialists
- Observations of care on wards
- Patient shadowing, as per the King’s Fund approach
- Staff handovers to include safety briefings
- Ward Liaison Officers working with the wards to help resolve issues and challenge current practice, removing any blocks or delays in the system to ensure patients are treated in the most appropriate place and get home faster
- Identification of pressure ulcers, falls, medication errors and healthcare acquired infections with a timely review, including by the relevant specialist
- Pharmacists working longer hours, seven days a week
- More timely access to scans and tests, with longer opening hours
- A larger number of therapy staff (such as physiotherapists) working with the Emergency Department, so that patients can go home more quickly.
How will this affect GP practices?
Throughout the Perfect Care Week, healthcare providers will be working together to try and improve things for patients and make things happen. For GP practices A&E may use the direct dial numbers practices have given (under the Unplanned Admissions Enhanced service) to redirect patients back into primary care when appropriate, and ask practices to offer an appropriate follow up appointment for patients. When referring a patient to an emergency admissions unit during the Perfect Care Week, GPs are more likely to speak with a hospital doctor to agree appropriate care for their patients.
The Perfect Care Week is unlikely to have any significant impact on the day-to-day working in GP practices but co-operation is required, particularly if practices are contacted by A&E re-directing patients. Designed to significantly improve patient flow, patient safety and, ultimately, patient experience and outcomes, the Perfect Care Week should empower frontline healthcare workers and help to improve the flow of patients, and increase bed space. It is ultimately a learning process and in the long term it is important we learn from this initiative and build on any improvements made.
Read the Self Care Forum manifesto here