What is the challenge your project is going to address and how does it connect to the theme of 'How can we improve across system boundaries?​

The ICB Nursing team often support staff in the care sector to access equipment and wish to explore an innovative approach facilitating more timely response to residents needs who require short term equipment and how that might  support the wider system in collaboration with the equipment supplier.

Often residents require extra support for a short period of time but by the time equipment is prescribed, ordered and delivered the need may have gone but in the meantime the resident has struggled and lost independence with longer recuperation time.   Without access to appropriate equipment staff then also are at risk of workplace hazards and injury.   If a resident struggles to have their needs met they are then at risk of avoidable harm, e.g deconditioning or a fall and subsequent conveyance to hospital or referral to primary care.  A pilot site has already reported a 50% reduction in falls after  5 months.

What does your project aim to achieve?

*To support on site provision of  low-level equipment for short term use,  ensuring timely access to community equipment for resident care needs
*To prevent avoidable harm and support safe, quality provision of care, enhancing resident experience and quality of life
*Support care professionals in the delivery of safe care
*Improve staff wellbeing, reducing occupational hazards
* Explore how the pilot could reduce wider system pressures
*Explore the financial impact of such a model to support system efficiency and effectiveness for all stakeholders  (currently over a milliion pounds of equipment is ‘lost’ in community                                                                                                                                                          *Reduce waits and and provide equitable access to the right equipment at the right time  * identify learning to inform improvement of current systems and processes benefitting the  wider system but ultimately resident care and ensure sustainability built in through embedding person centred focus                                                                                                                        * Prevent waste from over prescribing and surplus stock

How will the project be delivered?

The project will be delivered through the Nursing team who have proven skills and expertise in QI programme management.  The team will collaborate closely with care sector colleagues whom they have positive relationships with,  the equipment supplier and colleagues in contracting.

This approach will enable rounded measurement including for example:

• Staff training (care/ admin and maintenance staff)
• Utilisation of equipment and duration
• No. of residents who benefit from onsite access to equipment provision
• Resident and staff experience
• Monitor avoidable harms/ incidents, aim for reduction as an outcome measure i.e. falls, staff injury
• Capture  unintended consequences (positive & negative)
• Identify potential savings for the system by not utilising clinicians to prescribe equipment (time and finance)
• Identify the saving for equipment supplier
• Identify time saved for care staff, reduction of admin time
• Identify how many residents go on to require longer term use of the equipment

How is your project going to share learning?

Once presented to the Q Exchange programme colleagues there are plans to disseminate the evaluation widely.  This includes;

• Communication team in the ICB
• Spread findings at key meetings (local, regional, national)
• Share with Local Authorities who may be interested in the approach as transferable learning
• electronically/ social media posts
• Linking with ICB collaboratives to share practice across forums
• NHS England networks
• Equipment supplier networks
• Contracting & finance teams
• Partners in Care Bulletin and Care connected provider forum across NY & Y,
• Y & H AHSN,
• CQC colleagues
• Acute and primary care colleagues alongside other agencies
• Social care colleagues
• Stakeholders such as Health Watch, independent care groups
• If successful it would be good to explore how further settings might benefit such as extra care and supported living provider
• Aim to share as widely as possible