Read the Report
The Final Report for this study is now available. Please download it by clicking on the link below.
Evaluation of the Nairn anticipatory care project
Project Summary - Please find the background, aims, methods, key findings and recommendations for this project
Background
The Nairn Anticipatory Care Project was developed to target proactive anticipatory care to the patients who have the most complex needs and co morbidities, identified as those with the highest score by the Nairn Case Finder, in order to prevent emergency hospital admissions and reduce bed utilisation. This is at the fore front of NHS Scotland health care policy. For each of these patients, a health status assessment is conducted and an Anticipatory Care Plan (ACP) is developed, which includes some common anticipated events, such as: carer illness; acute medical problem; acute surgical problem; slow gradual decline of multiple chronic diseases; preferred place of death and resuscitation status. The Anticipatory Team (ACT) additionally provide reactive immediate support and care for patients referred for either supported discharge from hospital or prevention of hospital admission.
Aims and Methods
The aim of this qualitative evaluation of the Nairn Anticipatory Care Project was to assess the patient experience of the care provided and to examine the efficiency of this management method of people with complex needs. This evaluation considered both service user and service provider perspectives.
The researcher conducted semi-structured face-to-face interviews with patients who had been involved with the Nairn Anticipatory Care Project. In addition, the researcher conducted semi-structured interviews and focus groups with members of the Nairn ACT and health and social care professionals from associated statutory bodies. Interviews and focus groups were recorded and transcribed verbatim. Analysis was conducted using appropriate qualitative analysis techniques and software (Nvivo v7.0).
Key Findings
The ACT provides health and social care information and support in the heart of the community; it is accessible and deemed to be very effective for those people ‘at risk’ or ‘in crisis’ who were interviewed as well as by professionals who referred people to its services. Some patients placed an emphasis on the reassurance they were given on the potential future issues related to living with of a long-term condition whilst others emphasised the value of the emotional and practical support they received which enabled them to regain their confidence and independence
"I think the benefit that I've got is the knowledge that if anything happened to me and I really needed somebody, I now know who to contact and that help would be available"
Recommendations
Successful implementation requires clinical leadership and a skilled motivated, multi professional team
The ACT need to clarify its remit to characterise both the proactive anticipatory care and reactive immediate care that it is currently providing.
NHS Highland and the Highland Local Authority should work together to identify the main issues and barriers to anticipatory care planning and support services in Scotland. Such a study should investigate the delays in the provision of social and health care services, methods of assessment, limitations of use and what could be done to accelerate assessment and placement of support for people being discharged from hospital or for people in the community who have long term conditions, but urgent, short-term support needs. People who use these services should play a key role in designing and developing such a project
Funding Organisation
NHS Highland