We are continuing to work hard to find responses to the ongoing challenge and pressures we all face. Your continued support and understanding on the steps we are having to take is greatly appreciated. Actions taken most recently are:

Community Nursing response to pressures – Teams continue to experience significant pressure, exacerbated by some system-wide pressures and industrial action. Our wider teams continue to support the wider system with admission avoidance and discharge. As a result of these challenges the Locala Community Nursing service is in OPEL 4 and we are managing life critical and essential patients as a priority. A number of initiatives are being introduced to help, including:

• increasing support with self-care
• working in partnership with care homes
• introducing additional clinics
• reducing inefficiencies to divert non-clinical tasks from nurses

Locala attendance at MDTs - The pressures have impacted attendance of MDT’s across Kirklees which is regrettable. The pressures we are seeing are likely to continue and there is reduced workforce capacity to attend MDTs due to the need to prioritise patient care; however, we recognise that communication around non-attendance needs to be improved. There is also work underway to review and improve MDT attendance as these pressures lift. We remain committed to the MDT process and would be very willing to look at the possibility of MDT attendance via MS Teams if that is something you would wish to explore.  

Referrals to Community Nursing – We are now having to more robustly triage all patient care, and new referrals. Any patients that are referred, who do not meet the service criteria, which will include a review of their housebound status, will unfortunately not be accepted onto the caseload. Changes have been made to the e-referral form to support this approach including more mandatory fields, and a question to assess whether self-care has been considered with the patient. If the patient does not meet the agreed service criteria, as set out in the service contract, the referrer and patient will be informed of the decision. We welcome your support to provide the correct information to patients with regard to community nursing eligibility.

Housebound definition – Now more than ever it is critical that community nursing is available to those who need it. This means we are placing a greater focus on the definition of a housebound patient. The definition used, taken from the new specification for the contract, provided by the commissioners as part of the CC2H review process, is: “A housebound patient is one who cannot leave their home at all, or without significant assistance which cannot be provided, either temporarily or permanently, due to severe physical or mental or illness or disability.” With the exception to palliative care patients who will always be seen in their own homes.

If you are not sure about where to go if a referral is refused then you can contact John Moran – john.moran@locala.org.uk for a conversation - we will endeavour to support and enable referrers to better understand possible the alternatives for patients.

It is important that we work as a system to address the challenges we all face, so we will keep communicating with our partners, and continue work together to identify innovative ways to tackle the issues we are all facing.