A visit was carried out at Mrs Hanner’s (1) property. A referral was made to us from Adult Social Care following a stay in hospital. Mrs Hanner was living alone with early onset dementia. There was an increased risk of fire due to cooking and electrical overloading. Mrs Hanner was very confused. After some discussion with her, it was found that she was not eating properly, was lonely, and was isolated. Mrs Hanner was without a family support network locally. Just one referral was needed and achieved life-changing results.
A follow-up visit was carried out by our Safe and Well Practitioners to check if everything had been put in place to help Mrs Hanner stay safe and well within her own home. Since the previous visit, a care package had been put into place with carers visiting daily. Not only is there a lowered risk of fire, but Mrs Hanner is also receiving help with personal care, cleaning, laundry, and shopping. A meals-on-wheels service is also in place. During the follow-up visit, it was noted that Mrs Hanner was less confused and noticeably happier, stating that she looked forward to her carer’s visits and felt less isolated.
ESFRS is working collaboratively with our local clinical commissioning groups to identify patients who are at increased risk of unplanned admission to hospital. A Safe and Well visit is offered to reduce the risk of accidental injury within the home, therefore reducing the risk of admission to hospital as the result of a fall or other safety related incident. These referrals are made through an information-sharing agreement that removes the need for GPs to make time-consuming individual referrals. We are planning to develop this scheme across the whole service area.
1 Mrs Hanner’s name has been changed to protect her identity.
Hampshire Fire and Rescue Service has developed a programme for teenagers to promote a healthy body and healthy mind, called A Better Me. This programme is a series of sessions focusing on a healthy lifestyle, while building the candidate’s self-confidence and self-esteem.
Health professionals have identified that the main health issues affecting youth within Hampshire are:
• Obesity (Either Currently Overweight or Likely to Become Overweight
• Long-term Medical Conditions (e.g. Asthma, Type 2 Diabetes, Eczema, Epilepsy, etc.)
Hampshire Fire and Rescue Service worked in partnership with local health professionals, co-designing the programme to improve these aspects of a candidate’s lifestyle.
The course includes team-building exercises, physical activities, and nutritional information. Each week, candidates are introduced to local clubs, and always eat a healthy meal with the firefighters. The aim is to provide people with the knowledge needed to make healthier lifestyle choices.
Hampshire Fire and Rescue Service felt that they were uniquely placed, as the centre of local communities, to engage with younger people. They felt they could use their professional reputation to encourage participation from younger people who often don’t feel confident enough to join groups or health programmes. It is a great opportunity to bring the fire service’s knowledge of prevention techniques to the health issues facing young people today.
The success of the programme is determined by evaluation by Public Health England, and the local clinical commissioning groups. The programme is also independently, externally evaluated by PhD students from the faculty of life sciences, University of Southampton. The evaluation process encourages input from schools and parents, as well as self-reporting by the candidates attending the course.
Initial results have shown that candidates are more active and are making healthier food choices following the completion of the course. They also show an increase in self-esteem and confidence.
The One Stop Surrey referral system allows members of the public aged over 60 to be referred to 28 other agencies, offering support and services under the Surrey Living and Ageing Well Agenda. The system enables fire crews to give signposting to other services, supported by Surrey County Council. This provides the opportunity to reduce social isolation, and delivers access to services that can improve the individual’s quality of life.
The One Stop Surrey referral system is used as part of Safe and Well visits by fire crews in Surrey, covering a fire safety visit with advice and, when required, free smoke alarms. Members of the public can also self-refer via the One Stop Surrey web form, found via this link.
In 2016-17, using NHS data on those aged 65 and older, Surrey doubled the number of people offered Safe and Well visits. In 2017-18, Surrey Fire and Rescue Service is looking to move away from this way of working, and receive requests for Safe and Well visits from other agencies, including GPs.
SFRS are currently working with Surrey’s Health and Wellbeing Board, and six CCGs, on Fire as a Health Asset around data use, fall prevention, and telecare response.
Visit the Surrey Fire and Rescue Service website for more information about their Fire as a Health Asset work:
Kent Fire and Rescue Service (KFRS), Medway Council, Medway Clinical Commissioning Group (CCG), and the voluntary sector have developed a whole system approach to delivering prevention services that build upon the success of our Proactive Assessment Clinic for the Elderly and KFRS Safe and Well visits (SWV).
Global evidence, such as the Canterbury system in New Zealand, shows that a personalised prevention whole system approach can support major reductions in high-cost step-up care while providing excellent citizen and staff experience.
A collaborative, clinically led approach uses scientific methods to co-design interventions that would add value by identifying early signs of frailty thus reducing the risk of falls. A suite of process and balancing measures have been adopted to ensure that we meet our required outcome in a safe, timely, and effective manner while allowing interventions by KFRS to be tested.
The electronic frailty index is being embedded in our systems to prioritise SWVs for those most in need. NHS Medway invites patients with moderate-to-severe frailty to a special clinic for a comprehensive geriatric assessment. This is augmented with a SWV to ensure that we are maximising risk avoidance through a safe home environment. We are also embedding an electronic system that will facilitate prompt and efficient referrals for community-based intervention. The partnership will continue to develop the system to ensure our population age well in their own home, where possible.
During the period October 2016 to April 2017, KFRS completed 687 Safe and Well visits within the Medway area. During this period, 220 of the Safe and Well assessments identified someone over 65 with mobility issues.
As part of the test to change process, when a significant risk of falls has been identified a formal assessment will be completed on behalf of the CCG. This process was not implemented until January 2017 and a total of 62 evaluations were completed by the end of April 2017. Because of these assessments, 16 referrals were made into the falls service.
KFRS is continuing to work with Medway CCG to test and evaluate different interventions which, it is hoped, will reduce the likelihood of someone having an initial or repeated fall. The success is being measured through feedback from staff and customers. However, as part of a wider project, the service is working closely with Kent Public Health Observatory to measure and evaluate outcomes from its Safe and Well visits across the STP footprint. This is being achieved through the Kent Integrated Database, which enables KFRS data to be analysed against health outcomes such as admissions to hospital.