CSIP was asked to evaluate the shift of resources from inpatient wards at Folkestone to a comprehensive range of health and social care services provided in the community.

CSIP was asked to evaluate the shift of resources from inpatient wards at Folkestone to a comprehensive range of health and social care services provided in the community.

These services were intended to support people following discharge from an acute hospital setting, or to prevent their admission into inpatient or long-term care if appropriate.

There was a particular requirement, following the expansion of the service during 2005, to be able to show that the intermediate care services were effective and efficient. It also needed to be shown that the closure of two wards in Folkestone did not result in more delayed transfers of care, longer stays and more readmissions to the William Harvey Hospital in Ashford.

The initial review in December 2005 highlighted the need to collect reliable activity data for all aspects of the new range of services. This included referral rates, discharge destinations, length of stay, occupancy levels and appropriateness of admission. This would allow its effectiveness in preventing hospital admission or admission to long-term care to be measured.

Length of stay reduced
The final review in June 2006 demonstrated that the intermediate care services were providing safe, appropriate, timely care, 'closer to home' and meeting people's needs. The services are being delivered within the agreed budget to the targets set out in the operational policy.

Based on referrals during the previous three months, it was estimated that 431 acute bed days were saved as a result of interventions by the intermediate care team. Emergency bed days in Shepway primary care trust decreased in the same period by 26 per cent, compared with a national average of 10 per cent. Emergency bed days after admission via GP fell by 48 per cent, compared with a national figure of 9 per cent.

The average length of stay for Shepway patients fell dramatically from 32.44 days in April 2004 to 21.28 days in October 2005, and 14.56 days in April 2006. This was attributed to the success of the in-reach team, part of the intermediate care team.

For further information contact CSIP evaluator Cathy Smith at cs.associates@virgin.net