Leeds Older People with Frailty and COVID-19: Enhanced Care at Home Pathway

Update on pathway - 1 December 2020

Contents

Enhanced Care at Home Pathway

LTHT, LCH, primary care and the Leeds hospices have developed a set of protocols to enable people who prefer to be cared for at home, including those who are able to be discharged from hospital to receive an enhanced level of care. This includes access, as appropriate,  to home oxygen, intravenous therapies, sub-cutaneous fluids, specialist palliative care and enhanced monitoring.

To access this support for people at home/in the community please see the following guidance and the information on this page.

To support discharge from hospital please see the following Enhanced Community Offer Quick guide for hospital clinical staff document.

Geriatrician advice line

The Geriatrician advice line can be accessed from 9am to 5pm Monday-Friday by calling Leeds Teaching Hospitals Trust switchboard on 0113 2433144 and asking to be put through to the Community Frailty Response Consultant. Outside of these hours the on-call registrar or consultant geriatrician can advise  

Supporting people at home

Please see below the relevant flow charts and documents detailing the additional care that is on offer to support people at home (including in care homes) in particular how to access and prescribe home oxygen and sub-cutaneous fluids.

Please note that this offer will be available with immediate effect and is optional for General Practice to access working in partnership with Geriatricians and LCH Neighbourhood Teams. It should only be used for patients where admission to hospital is not thought appropriate:

  • After discussion with the patient and carers their preference is to remain at home and receive appropriate supportive care

AND

  • GP agrees admission not appropriate and happy to support at home

This care at home should be instigated by contacting the Geriatrician advice line.

Linking to the Virtual Ward (frailty)

This care will be delivered in partnership with the Virtual Ward (frailty) which is now operational in all areas of the city. See the virtual ward (frailty) referral leaflet for more information.

Sharing good practice

It would also be good to hear positive comments and examples where this has been accessed successfully so that these can be shared. Please email leedsccg.systemintegration@nhs.net

Guidance documents – Enhanced care at home

Guidance documents – Specialist Palliative Care