Ask your average person in the street which authorities keep the public healthy, and naturally our great NHS would come first, with councils down the pecking order. But a major part of councils’ work has always been about keeping people healthy, and a year ago Croydon LBC took this principle a big step further by launching a groundbreaking partnership with the local NHS and Age UK Croydon.
Now called One Croydon, our alliance’s aim was to break the cycle of hospital admissions for people over 65 with long-term conditions by providing personalised care closer to home and support to live more independently.
Although this brings undoubted financial savings to cash-strapped public sector authorities, the alliance’s main goal is to give a new lease of life to people who would otherwise be stuck in a demoralising revolving door of acute care and accelerating care needs. This also involves shifting expenditure from delivering acute care towards prevention work and support in the community.
The successes so far have been very encouraging. There have been 62% fewer patients needing care packages for longer than six weeks after leaving hospital, and a 20% reduction in the length of hospital stays. In the project’s initial three months more than 450 of our residents either had a reduced length of stay in hospital or avoided admission altogether. In that short time period, the council saved £200,000 in adult social care costs; money that was then spent on coping with extra demand over the winter.
Achieving this has meant unprecedented levels of joint working across the alliance, which is comprised of six organisations in the borough; Croydon Clinical Commissioning Group (CCG), Croydon Council, Croydon GP Collaborative, Croydon Health Services NHS Trust, South London and Maudsley NHS Foundation Trust, and Age UK Croydon.
At hospital, Croydon LBC social workers and NHS staff work together to assess an elderly person’s medical and social care needs. Working in the Accident and Emergency department, the team’s skills and knowledge help avoid admissions, including spotting regular visitors and offering a swifter and more personal response to get them home. Even small changes have helped improve people’s lives, such as reducing the wait for hospital discharge by cutting assessment forms from 30 pages to four.
At the resident’s home, they receive care from the council and health services that will aid their recovery, promote their independence, avoid another hospital readmission, and reduce their need for ongoing home support. This could be as simple as relearning to dress and wash themselves rather than a carer doing it for them, or it could be about getting a new lease of life.
At the GP surgeries in Croydon, professionals from doctors to social workers involved in a person’s care discuss their needs at a weekly confidential meeting called a huddle. This is not just to review their health needs but to also see individuals’ overall needs more clearly. This could lead to visits from a Personal Independence Co-Ordinator (PIC), one of 18 employed by alliance partner Age UK Croydon for up to a 12-week period to find new activities or support services that improve the resident’s quality of life.
And these improvements aren’t just restricted to those who commission services; it helps those who bid for and deliver contracts. For example, local voluntary groups that might traditionally try to outbid each other for council grants are now being encouraged through a new local commissioning model to pool their resources and work together to support the needs of residents.
Above all, the alliance’s biggest success has been giving residents greater independence. For example, one woman in her eighties who benefited from the programme had been previously left housebound with vertigo, dizziness and tunnel vision after a bleed on the brain. Having her own PIC and wider support from the One Croydon alliance has now led to her getting a zimmer frame for better mobility, joining a local needlework group, and going on trips for tea and meeting new friends. After being used to frequent hospital stays before joining the programme, since then she has not needed it once.
The alliance has supported hundreds of people already, and its successful transition year has now been renewed from this April for a 10-year partnership. One Croydon’s ambition is for the alliance’s remit to expand to include residents of any age, and all disabilities. Other London councils have already got in touch that are exploring their own version of our partnership.
There is so much more to do, but One Croydon is allowing the council and its partners to overcome hurdles together to give many people in our borough better outcomes and quality of life. So hopefully, in time, even more people in the street will understand the growing role that councils play in keeping them healthy.
Cllr Louisa Woodley is Croydon LBC’s cabinet member for families, health and social care
