Improving productivity and efficiency in community care: HomeLink Healthcare’s partnership with an NHS Trust in the East of England

Winter is a challenging time for the NHS, with increased demand for services placing a strain on already stretched resources. In the winter of 2023, an NHS Trust in the East of England faced a significant increase in demand for community nursing services. The pressure was particularly intense for planned care and Urgent Community Response Teams (UCR). In collaboration with the local Integrated Care Board (ICB), the Trust and HomeLink Healthcare co-designed a service to increase capacity and improve efficiency.

HomeLink Healthcare, a well-established provider of out-of-hospital services across four NHS England regions, had previously been commissioned by the ICB to set up a managed service, providing additional seasonal reablement capacity in the area. To meet the challenges of the 2023/24 winter, the ICB turned to HomeLink once again to help with community services across their region. With a proven track record of delivering safe, high-quality clinical care to NHS patients and a proven ability to mobilise swiftly, HomeLink was chosen by the Trust to provide additional resilience.

Working together, the Trust and HomeLink Healthcare identified two key pathways where our community team of Registered Nurses and Healthcare Support Workers could make the most impact – wound care for care home residents and at-home phlebotomy services. This allowed the Trust’s community teams to focus resources on other essential planned care and UCR activities.

Safe, effective delivery of the new service was achieved within four weeks, using the PRINCE2 project management approach, and led by a dedicated HomeLink Healthcare project manager across several interrelated workstreams, from service design to clinical and information governance; IT; contract and finance; communications; workforce and recruitment. Before going live, the service was rigorously tested to ensure patient safety.

One of the initial challenges in delivering the new service was the wide geographical area it covered, with patients spread across a largely rural region. This resulted in longer travel times between patient visits, which could have impacted efficiency. However, the local knowledge of our staff proved invaluable, as their familiarity with the area allowed for more effective scheduling. By reducing travel times and maximising patient-facing hours, we were able to boost productivity and increase the number of patients seen each week.

The service was delivered with a strong emphasis on collaboration and communication between HomeLink Healthcare and the Trust. In addition to daily updates from the HomeLink team, weekly meetings were held to discuss caseloads and address any problems or issues that arose. Monthly service reviews further developed the ethos of partnership working and included reporting KPIs for the service, such as the number of visits delivered, length of stay, as well as clinical quality and safety indicators. All patient encounters (visits) were shared with the Trust on a daily basis. By providing full access to our patient notes and keeping the Trust informed of any issues or incidents, close integration of clinical records was achieved.

Key outcomes:

• Improved patient flow: Over a 6 month period, HomeLink Healthcare delivered 3,048 patient visits, which included 1,564 patients seen for blood tests and 212 patients in care homes treated for wound care. Following an initial ramp-up period, we reduced the waiting list for phlebotomy services by 100%, from 300 unallocated visits to zero in five weeks.
• Patient satisfaction: 100% of our patients said they would highly recommend us to their friends and family, and 100% said they would be happy to be treated by HomeLink at home again.

The collaboration between HomeLink Healthcare and the Trust successfully addressed planned care needs and released much needed staff for UCR services. By freeing up the Trust’s resources, the partnership not only improved patient flow and reduced the waiting list for phlebotomy services, but also helped to address inequalities in access to healthcare, ensuring that more patients received the care and support they needed.

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To find out more about the process of commissioning HomeLink Healthcare to set up a Hospital at Home service, click here.

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