Robert spent the best part of 11 months in hospital after suffering shortness of breath and rapid weight loss. He lost his wife during that time and the outlook for the 77-year-old seemed bleak. But now he is living independently with help to maintain his home and garden, advice on benefits and tips on healthy living.
The transformation in Robert’s life reflects the evolution of health and care services in Croydon, south London, where the local council, the NHS and charity Age UK Croydon have come together to support people like him.
The One Croydon Alliance was given the green light in March to develop its work for the next nine years, after demonstrating early benefits, including a 20% reduction in length of hospital stays, up to 14% fewer hospital referrals by GPs and cash savings of at least £12m a year.
Jo Negrini, Croydon council’s chief executive, says: “This unprecedented level of joint working between council staff, the NHS and other alliance partners has meant better health and social care outcomes for residents who might otherwise have continued to [be] in and out of hospital.”
The alliance was set up last year for an initial 12 months during which it focused mainly on people aged 65 and over. The two principal strands of its approach have been a Living Independently for Everyone (Life) programme – an integrated reablement and rehabilitation service for older people on discharge from hospital – and an Integrated Community Networks (ICN) scheme based on weekly “huddles” of professionals from all disciplines to discuss people at risk of going into hospital.
These huddles, with support from an Age UK personal independence coordinator, are critical to keeping Robert living at home.
Rachel Soni, the alliance’s programme director, says the whole-system initiative stemmed from a realisation by care commissioners that expecting care providers to work together was only half the battle – it was “throwing stuff over the fence” for other organisations to deal with.
Key to the first-year success of the alliance has been the strong commitment at the most senior levels of all the partner organisations, bottom-up co-design of the programmes and neutrality of the coordinating team, says Soni. “I report to the chair of the GP collaborative [a grouping of family doctors] but I am a council employee and I am on secondment to the [NHS] clinical commissioning group.”
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