Frailty Support Team: proactive and reactive care for people living with frailty in the New Forest.


Short Title Frailty Support Team: proactive and reactive care for people living with frailty in the New Forest.
Category Crisis (decompensation) / Severe Frailty
Organisation Southern Health NHS Foundation Trust with Primary Care
Contact Name Esther Clift
Contact Email Esther.clift@nhs.net
Web Link
Sector Healthcare
Region Hampshire
Postcode SO41 8QD
Active Yes

Description:

Reactive: managing people through a phase of acute decompensating of frailty to enable them to stay at home safely. Referrals coming from GPs and SCAS as well as the on call consultant at Lymington Hospital
Proactive: supporting Care Homes in managing people living with frailty and ensuring robust escalation of care plans are written and agreed with residents and their families Care homes selected on their need for proactive support.

Outcome:

Reduced unplanned hospital admissions (through Emergency Departments) and facilitating care at home with high level of clinical support and diagnostics.Enable more people to achieve their preferred place of care at end of life.


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