NHS England Innovative Practice Award – for developing an admission avoidance service model
Since 2021, we have prevented 3500+ service users from being re-admitted into hospital through our Rapid Response Service.
| Reduced Package of Care (POC) | 47% |
| Discharged with No POC | 38% |
| Taken Over By Reablement Team | 5% |
| Admitted into Hospital | 5% |
| Taken Over By Reablement Team | 3% |
| Moved to Nursing/Care Home | 2% |
In Bedfordshire, under a sub-contract
with ELFT, we provide rapid response
and reablement homecare services
We have been awarded zonal partners
and shadow strategic partners with
Oxfordshire County Council.
We are also preferred and approved
providers in Central Bedfordshire &
Bedford Borough.
Diabetes monitoring involves regularly tracking blood glucose levels and other related health indicators to manage diabetes effectively.
This includes:
- Blood glucose levels outside of target ranges
- Symptoms of hyper- or hypoglycemia
- Changes in weight, diet, or physical activity.
- Signs of diabetes-related complications (e.g. problems with the feet, vision changes)
- Adherence to medication and lifestyle recommendations.
- Glucose monitoring devices, including continuous glucose monitors (CGMs).
- Regular data analysis and trend reviews
- Improved glycemic control and overall diabetes management.
- Reduced risk of diabetes-related complications
- Enhanced understanding of how lifestyle factors affect your condition.
- Increased confidence in managing your diabetes.
- Seamless integration of diabetes care into your daily life.
Effective diabetes monitoring is crucial for maintaining optimal health and preventing complications associated with the condition. By consistently tracking blood glucose levels, adhering to medication regimens, and making informed lifestyle choices, individuals with diabetes can significantly improve their quality of life.
| Reduced Package of Care (POC) | 47% |
| Discharged with No POC | 38% |
| Taken Over By Reablement Team | 5% |
| Admitted into Hospital | 5% |
| Taken Over By Reablement Team | 3% |
| Moved to Nursing/Care Home | 2% |
In Bedfordshire, under a sub-contract
with ELFT, we provide rapid response
and reablement homecare services
We have been awarded zonal partners
and shadow strategic partners with
Oxfordshire County Council.
We are also preferred and approved
providers in Central Bedfordshire &
Bedford Borough.
~ Pamela B. - Service User
Our Health Care Assistants undergo the highest standard of comprehensive training in medical skills, equipment use, emergency response, patient education, communication, infection control, and cultural competence.
All completed training is signed off by our Advanced Nurse Practitioner
Our service runs 7am-10pm daily, including weekends, with 24/7 on-call coverage and a single point of access for all referrals.
By collaborating and partnering with various healthcare providers who are already involved in community-based care, this service aims to create integrated, multi-disciplinary care pathways
This allows for smooth care transitions, sharing of information and assessments, and a comprehensive, coordinated approach to treating patients intensively in their home environment while avoiding unnecessary hospital admissions.
The Gold Standard Framework (GSF) is a widely used training program and accreditation process focused on enabling high- quality delivery of palliative and end-of-life care, both in hospitals and community/home settings
We aim to ensure our clinical teams, protocols, and care pathways meet best practice standards for providing comprehensive, compassionate palliative and end-of-life care to patients being treated at
