Nottingham CityCare Partnership - The Holistic Worker model

Nottingham CityCare Partnership is a social enterprise delivering community healthcare in Nottingham. A need for change was identified within Adult Services Urgent Care team in response to necessity. The holistic worker model of integrated working was initially commissioned as a pilot to urgently assess patients in their own home following a referral from a GP, an ambulance team, a social care assessor or a health practitioner. It was developed to change the way that care is delivered to older people with long-term conditions, avoid unnecessary admissions to hospital or care homes and provide tangible social benefits. Prior to the model being developed, different teams worked in a very individual way, despite being a multi-disciplinary team. Each patient would have 4 separate assessments by a nurse, physiotherapist, occupational therapist and social worker, and they would need to keep repeating their story.
Each member of the team is now trained in each other's disciplines up to the level of 'general assistant practitioner' and this enables one team member to carry out a wide range of practice help and assistance during a visit to a patient's home. If more specialist intervention is required the individual can make a referral to other colleagues in the team as appropriate.
Patient care has benefited from the improved confidence levels reported by all team members, who feel better equipped to manage unexpected situations, with a deeper understanding of each other's professions. Patient satisfaction remains high and was over 95% at the time of filming; the number of inter-team referrals has reduced significantly and a patient has fewer visits with better outcomes and experience.
Visit www.england.nhs... to find out more about Leading Change, Adding Value and access a wealth of resources available to support nursing, midwifery and care staff in making the changes necessary to improve the outcomes and experiences for those they care for.