The overall aim of the enhanced clinical support for care homes was to provide a new multidisciplinary approach to deliver clinical outcomes, engaging patients and relatives in decision making to promote dignity.
The multidisciplinary team involved general practitioners, advanced nurse practitioners, dietitian, pharmacy technician, pharmacist, nurse educator and care home staff.
The main outcomes achieved are linked with the NHS outcomes framework domains. At a local level the main outcomes experienced were a reduction of avoidable emergency admissions, provision of proactive care planning with informed treatment escalation/ceiling and risk reduction, improvement in joint planing/communication between the wider team and residents and families, reduction in polypharmacy, systems simplification, promotion of dignity at the end of life, reduction in the impact of frailty, improve CQC rates and maximise nutrition and hydration and waste reduction etc.
