The Hawkinge House Proactive Assessment Unit (PAU)
Community care as an alternative to hospital
The Proactive Assessment Unit (PAU) enables people to be assessed for their community care needs without staying in acute hospital beds.
What does the PAU do?
- Provides an environment for patients’ assessments that feels like an extension of their home rather than a hospital – “Home from Home”
- Enhanced clinical care in a safe, family-friendly environment
- Care as an extension of the patient’s General Practice without making extra work for the GP and their community team
- Use of the patient’s own electronic GP record for the stay to ensure seamless care, not just admission and discharge
- Provides a safer environment for complex patients to stay in the community rather than staying at home without diagnostics and monitoring, reducing the need to dial 999, attend A&E or acute admission
- Provides enhanced medical and therapy input to support primary care in the community
How does the PAU do this?
- Additional GP input to ensure clinical needs are met, linked to the patient’s own practice
- Additional consultant input (medical and psychiatric)
- Identification of respiratory and urinary causes reducing inappropriate antibiotic prescribing and reducing microbial resistance
What does the Proactive Assessment Unit (PAU) look like?
Click the buttons on the diagram below, or click here for full picture.
Fully equipped bathroom Disabled friendly Respects dignity Facilitates independent personal care
Family-friendly environment Personal social seating space Sofa bed for relatives and friends to stay Enabling carers to continue to care where appropriate
Dining table Able to eat on own or with family and friends Communal eating and social facilities as chosen
Own cooking facilities not institutionalised hospital care Able to make own hot drinks Microwave Fridge Available for family and friends
Interactive TV screen & Web cam Skype type with family, friends and own primary care team Virtual consultations with specialists Ability to see care plan real time
Modern therapies available 7 days per week Piped oxygen to all suites IV therapy including antibiotics, fluids and blood Pain relief management Interactive social activity with links to patient’s own community
Ultramodern monitoring Ability to detect the acutely deteriorating patient
Utilisation of own GP electronic record Record available to patient and relative Patient / Carer agreement with personalised care plan
Registered with CQC as a Community Healthcare Service supplying enhanced integrated care services 7 days per week Medical including additional GPs and consultants Nursing Therapies including physio, OT, tissue viability Pharmacy Social MDT personal approach to meet individual needs
Ultramodern diagnostics Onsite Community lab providing traditional and innovative diagnostics Access to William Harvey Hospital facilities available urgently as Virtual Inpatient (VIP) when needed
Relationship Centred Care TM Patient’s priorities met through personal ESTHER care coordinator Creative interactive environment Carer support Linkage with community and voluntary sector
How does the PAU support frail patients to have their assessment needs met in their community
Reduces emergency admissions to hospital
GP practices are increasingly expected to look after complex frail patients when they have increased clinical needs rather than referring these patients to A&E and acute admissions. This is causing significant pressure on an increasingly unsustainable primary care, particularly with the lack of acute diagnostics and community resources to visit and manage these patients safely.
The PAU provides enhanced and additional resources to manage this clinical risk, linking directly with GP practices and the community team including social care so that the patient is managed as an extension of their GP practice, accepting patients who do not have specific conditions including:
- Heart attack
- Potential surgical conditions
The proactive assessment service in the Hawkinge House PAU provides an innovative option for primary care to make “out of hospital care safer for both citizens and the professionals”.
This gives people confidence that their clinical needs will be met in a social care, family-friendly environment that will return them back to their own home when they are clinically fit enough to return.
Patients, carers, practices and communities choose the PAU rather than acute hospital care
Supports complex patients in their community
The PAU operates as an extension of the GP practice but without the need for the practice to provide any additional clinical input. It uses the existing GP clinical records and care plans to ensure that the additional clinical care is a seamless transfer of care – a stay rather than an admission or a discharge. It has a strong Multi Disciplinary Team approach looking at the needs of the patient rather than organisational needs, supporting and linking directly with the integrated community teams.
All members of the PAU team, including the carer, the community and the voluntary sector, are focussed on the individual’s total needs, thus reducing length of stay and recurrent admissions whilst setting up in-reach care into their own home.