A year on from the launch of a new adult community health service for west Hertfordshire, Herts Valleys CCG and Central London Community Healthcare NHS Trust (CLCH) have been reflecting on achievements over the last 12 months. As well as embarking on a programme of transformation, CLCH has also played a big part in the coronavirus response.

The CLCH service which started on 1 October 2019 provides nursing and therapy services for patients in the community covering areas including cardiac rehabilitation, bladder and bowel, tissue viability, leg ulcers, neuro rehabilitation, speech and language therapy and specialist palliative care. It is delivered by 700 staff working for CLCH as well as through subcontracts with four Hospice providers and Herts One GP federation.

The new service is working to transform patient care by working with GPs, mental health services, social care and voluntary services to support people in a more coordinated way. This is particularly important for people with complex needs who have various people involved in their care.

The aim is to help people stay well and independent and keep people out of hospital as much as possible.

Achievements over the past 12 months have included:

• A 24 hour palliative care advice line went live on 6 January.
• In January CLCH started a big programme of work to transform buildings including Harpenden Memorial Hospital, St Peters Ward (Hemel Hempstead hospital), Langley House, Potters Bar Hospital and Elstree Way Clinic, Borehamwood. Creation of new clinic rooms and refurbishment of existing ones, installation of air conditioning, reception area improvements and essential repairs to buildings are providing a better environment for patients.
• In March ‘step-up’ community beds were introduced to provide short term care for patients with complex health needs that couldn’t be managed in their home. These recovery beds help keep patients out of hospital.
• In April a new service started to provide time limited therapy in people’s homes as part of hospital discharge arrangements.
• In July, roll out started of a new Rapid Response service to support people following a health crisis, such as a fall. Patients receive treatment at home from a multi-disciplinary team to avoid them being admitted to hospital.
• From August heart failure services were enhanced with specialist nurses giving patients intravenous diuretics at home, where needed, to alleviate swelling and water retention.
• August also saw the introduction of new multidisciplinary support for patients with complex needs. This will see various professionals involved in looking after a particular patient coming together to plan and coordinate their care. These might include their GP, a consultant geriatrician, social care worker, therapist, mental health practitioner and social prescribing link worker.
• From September roll-out has started of a community frailty and falls service that will involve nurses, therapists and a consultant geriatrician assessing the frailty levels of individual patients to inform the care and support that people receive.

As well as delivering service transformation, CLCH has supported the response to COVID-19 in west Hertfordshire. This has included:

• Providing mobile testing for key workers and patients from Harpenden Memorial hospital
• Support for care homes including testing for staff and residents, training staff on using PPE and infection and prevention control and providing pharmaceutical support.
• Helping to provide a Covid virtual hospital, working alongside respiratory consultants from WHHT, to manage patients virtually in the community – thereby prevent hospital admissions and helping people to be discharged from hospital as soon as possible.

David Evans, Managing Director at Herts Valleys CCG said: “It’s great to see the transformation of services getting underway and new services starting that are already making a difference to our patients. On top of that CLCH has made an invaluable contribution to our coronavirus response. We are all hugely appreciative of the work that CLCH staff have done over the last year.”

Cathy Walker, Director of Operations in Herts said: “I’m incredibly proud of all our teams in Hertfordshire and like so many staff in the NHS, the last six months have presented challenges I’m not sure anyone could have predicted. It’s been inspiring to see staff face these challenges head on, demonstrating amazing tenacity and dedication to caring for the patients we serve.”

CLCH have made a short video to mark the first anniversary and the achievements of their staff over the year. Watch it here.