How we are working together

How we are working together
We are working on a number of projects with the local authority and local provider organisations that offer better care to people in our hospitals, care homes and their own homes. These projects will provide joined-up care around people’s lives, not forcing them to fit their lives around the care they need.

The following projects were agreed as part of the refreshed Improved Better Care Fund (iBCF), agreed in 2017:  

Wellbeing and Social Prescribing Service
The Wellbeing and Social Prescribing Service is a newly commissioned service to meet health and social care needs of residents by enhancing self-care, linking residents/patients in with sources of support within the community, developing community assets and networks made up of three elements:

  • Assessing (Identification of current/future needs and opportunities).
  • Linking (Motivating and facilitating residents to use available community assets).
  • Building (Developing existing assets and co-producing new community assets, where needed).

Active Recovery
The Active Recovery scheme involves developing six hubs across the East Riding (2 per year) to support hospital discharges and prevent admissions, with the aim of promoting and maximising independence, confidence building, improving mobility and regaining skills for daily living.  Each of the hubs will have a bed based element and a community based element, to support around 10 individuals at any one time.  Each hub will be supported by 10 care and support workers, one Occupational Therapist and one Social Worker.  When the service is fully developed, there will be 6 sites offering Active recovery beds across the East Riding, both in the community and in a mixture of sites in sheltered housing/extra care schemes/Woldhaven.  

Care Market
The Care Market scheme encompasses a plethora of projects within it to support, develop, and enhance the independent sector homecare and residential care market across the East Riding:

  • The development of an Enhanced Technology in Care Home pilot, which is supporting 8 care homes to have a dedicated laptop (improving access to summary care records in the first instance), secure Wi-Fi and secure nhs.net email addresses within each of the homes.  
  • The establishment of an innovation fund to support bids from care providers for monies which focus on improving quality, increase capacity, reduce attendances at Accident and Emergency departments, reduce unplanned admissions to hospital and are sustainable. 
  • Work to implement utilisation of a bed state tool across the East Riding which will enable up to date information on bed availability/vacancies across the East Riding, supporting earlier hospital discharges and reducing the number of delayed transfers of care.  

These initiatives build on the great work done as part of the original workstream projects which have now become business as usual. More information about the progress made in the areas of Ambulatory Care, Single Point of Contact, Prevention and Self Care can be found in our stakeholder bulletins.

Organisations involved

  • East Riding of Yorkshire Council
  • East Riding of Yorkshire Clinical Commissioning Group
  • Vale of York Clinical Commissioning Group
  • Humber NHS Foundation Trust
  • Hull and East Yorkshire Hospitals NHS Trust
  • GP Federations
  • Primary Care Practitioners
  • Healthwatch East Riding