Wexford General Hospital (WGH) and South East Community Healthcare (CHO 5) are integrating acute and community services for older people with their project Age Related Care (ARC) Team, which is funded by Sláintecare.

Build on services

Karina Somers, Advanced Nurse Practitioner explained that they wanted to “build on services that already existed but to integrate the work of the team to make care easier to access for older people. With a team including an Advanced Nurse Practitioner, a Senior Dietitian, a Medical Social Worker, a Senior Occupational Therapist, Senior Physiotherapist, we can integrate services, and give patients a route to make their care pathway more straightforward”.

According to Aideen McGuinness, Senior Dietitian: “Results of this project have been great for team members and patients, most of whom now rapidly get an appointment for a full geriatric assessment. This can be a long appointment, but it allows patients to access a range of services in one visit, avoiding multiple trips to hospital, and it reduces waiting times for individual services”.

The team initially had a target of 1,200 patients visiting the clinic but eventually achieved 2,389.  The project has successfully reduced waiting times for a geriatrician appointment have reduced from six months to six weeks, with non attendance rate at appointments reduced to three per cent down from the usual 10%.  Applications for long term care from the acute setting have reduced by 12% and delayed discharges have been reduced by 14%. 

Like a lot of services, ARC experienced disruption due to COVID, however they used some of these challenges to their advantage. Phone discussions in advance of appointments to screen for COVID reduced fear amongst their patients and increased attendance. As a result of social distancing guidelines, groups sizes for classes and other activities are smaller, which helps patients feel more comfortable, and allows them to get to know their doctors, nurses and therapists better.

"exceptional service"

Patient feedback has been really positive, with one patient describing it as an “”exceptional service. ” Another patient explained that “the morning is long but it is great to have seen the full team”. One service user's son said his mother was “a new woman after attending the appointment”.

ARC has been successful in securing long term funding through the Enhanced Community Care fund,  allowing for patients to access these comprehensive services on a long term basis. The aim of the team is to expand their services into four further locations in Wexford, New Ross, Enniscorthy and Gorey so that patients can have their appointments locally, and be able to provide home visits, really providing the right care in the right place at the right time.