New data released today shows that care homes who pioneered an innovative telemedicine approach to assessing residents following a fall, have seen a significant reduction in the use of ambulances and emergency hospital admissions. The data confirms that enabling vulnerable residents to receive rapid, high quality clinical care in a familiar environment reduces the risks associated with lengthy hospital stays and reduces pressure on local services and budgets.
Immedicare is a secure, video-enabled, clinical healthcare service linking care homes to the NHS with 24-hour access to a highly skilled, multidisciplinary clinical team based at Airedale NHS Foundation Trust. The service has been adopted by 780 UK care homes to date. The provision of consistent, high quality care is particularly important during the Covid-19 pandemic, as many care homes struggle with absent staff due to self-isolation, ongoing recruitment challenges and Government movement restrictions.
In the last 3.5 years, 105,144 video consultations were made from care homes who have access to the Immedicare central hub.1 Of these calls, 20,152 (19%) were related to falls.1 Following a falls related consultation with a clinical specialist, 83% of residents remained in their care home for assessment, follow-up and monitoring of their condition. Prior to installation of the service, care home residents would have been routinely sent to hospital for assessment after a fall, usually via an ambulance.
It is estimated that the service has saved the NHS nearly £10 million in less than four years in ambulance conveyancing and hospital admissions related to falls.1 If all 15,000 care homes in the UK were to use the service, it is estimated that the NHS could save over £250 million in ambulance conveyances and hospital admissions related to falls over the same period.
Mike Padgham, Managing Director of St Cecilia’s Care Services and Chair of the Independent Care Group commented, “It always benefits the resident if they can remain in the home rather than be admitted to hospital as an emergency, unless it’s truly necessary, and that’s the underlying principle of the Immedicare service. It gives care home staff and residents round-the-clock access to a highly skilled, specialist nursing team who can assess, manage and monitor their condition. We’ve always known this is the best approach for care home residents, but now we have the data to prove it. This service protects residents and care home staff and reduces pressure on local services and budgets. It should be a must-have service for every CCG.”
Falls in the elderly are a huge challenge. In 2018/19, there were over 225,000 falls-related emergency hospital admissions among people aged 65 and older in England alone. Falls and fractures cost the NHS an estimated £2 billion a year. Around a third of people aged 65 and over, and around half of people aged 80 and over, fall at least once a year. Older people living in care homes are three times more likely to fall than older people living in their own homes.5 Falls are the leading cause of emergency hospital admissions for older people.
Once admitted as an emergency, care home residents aged 65 or older spend on average 8.2 days in hospital. It can be a stressful and disorientating experience for elderly care home residents, of whom 69% have dementia or memory problems. In the current climate, the potential for distress is heightened by visitor restrictions and can lead to additional problems associated with worse health outcomes, such as hospital delirium, which affects a third of elderly patients admitted to hospital.
Rachel Binks, Nurse Consultant, Digital and Acute Care, Airedale NHS Foundation Trust and Clinical Lead for Immedicare commented, “The clinical risks associated with emergency hospital admissions provide a stark reminder of why we need to wrap specialist clinical care around our elderly residents and keep them out of hospital whenever possible. This has always been the case, but the pandemic has made it a priority and that’s why telemedicine has been adopted at a scale and pace never seen before in this sector. We have decided to share our data now to encourage more commissioners and care home providers to consider the Immedicare service as part of their long-term strategy for providing high quality care. As the data shows, it protects elderly and frail care home residents, as well as protecting local services, so it’s a win for everybody.”