Rapid Elderly Assessment Care Team (REACT)

Good practice:

Hospital level care within a patient’s own home

Scotland  / Rapid Elderly Assessment Care Team (REACT):  NA/1089 2/16

An important hallmark of a caring and compassionate society is to enable people to live independent lives, with meaning and purpose, within their own community. It is a fundamental principle of social justice, and a core element of West Lothian’s strategy to reshape healthcare and support services for older people. Especially for those with long term conditions.

Customer's need

The REACT programme reflects the ambitions of this strategy. It aims to manage demands by supporting people to remain at home. Avoiding the need for unplanned emergency admissions. It is an umbrella name for community services for the frail and elderly.

The solution

The REACT service has been designed to support HEAT targets (agreed national performance targets) by:

  • Reducing the rate of emergency in-patient bed days for people aged 75 and over per 1,000 population by at least 12% between 2009-10 and 2014/2015.
  • Reducing admission and emergency attendances for those over 75
  • Reducing delayed discharges 

The REACT team provides hospital level support and therapy interventions within a patient’s own home for a short period time as an alternative to being admitted to hospital.

Keys to success

  • Engagement of service users and families (generally very responsive).
  • Responsiveness to the workforce needs.
  • Workforce development and training.​

Good practice: Hospital level care within a patient’s own home

Good practice description

Following a GP referral, the REACT team provides hospital level support and therapy interventions within a patient’s own home. The team consists of one consultant, one doctor, four nurses, four physiotherapists, four occupational therapists, and one speech and language therapist. The support normally lasts for a short period, and offers patients and families an alternative to being admitted to hospital.

The REACT team provides the care and intervention required to support people to remain at home. To achieve this, it will carry out investigations, diagnose illness, and treat any medical conditions that can be managed at home. The team, in collaboration with the individual, will then decide the best intervention, and agree a treatment plan and/or therapy goals. The team also plays a key role is supporting patients returning home from hospital. They accept referrals from wards to speed up the discharge process where a higher level of therapy input is required. A database is maintained to record qualitative data. This includes response times, the time spent by patients in the service, details of follow-up contacts, mortality figures, the length of hospital stays resulting from referrals, and the related number of bed days saved.

The program

REACT was formed in May 2013. It followed an extensive plan to create a team that was physically, and in spirit, motivated by the overall goals of the project. It is a multi-disciplinary team, where professional and personal strengths have been identified and promoted. The team meets regularly. Not only to discuss cases, but also to ensure that progress is aligned with team objectives. This also ensures close integration with existing service provision. As a pilot, progress is closely monitored to consider the impact and effectiveness of the service, and the wider implications of the concept.

Contact information

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Lesley Broadley

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Pamela Main

References

  • Maximising Recovery, Promoting Independence: An Intermediate Care Framework for Scotland, 2012
  • A National Telehealth & Telecare Delivery Plan for Scotland to 2015

Program partners