Reflections 2022: Maz Fosh – Beavering away in the background to keep patients out of hospitals

It has been another challenging year, perhaps even more so, as we were hoping that moving to ‘living with COVID’ would alleviate some of the demands on the NHS. At times the pressure seemed relentless, but I know our staff put patients first, unfortunately, sometimes at the expense of their own wellbeing. So, I’d like to thank all colleagues and volunteers at Lincolnshire Community Health Services NHS Trust (LCHS) for their exceptionally hard work. Despite significant staffing pressures and ever-increasing demand, we have continued to provide care close to home.

When I think about community services, I imagine we’re the backbone of the NHS. Community services are not necessarily the first thing people have in mind when they think about health services. Still, we’re in the background as a link between primary care, hospital and home.

In 2022 we again focussed on services that keep people well at home or allow them to be discharged from an acute hospital without delays. Our Urgent Community Response (UCR) is just over a year old, and in that time, we helped thousands of people by seeing them within two hours and supporting them to remain at home without the need for a distressing trip to A&E. These are often frail or elderly patients who with a bit of help, specialist equipment or therapy support can continue to stay at home, which is much better for them. UCR allowed 83% of their patients to avoid acute hospital by offering rapid support when needed.

It is important that hospital beds are available to those patients who really need them and to support patients to go back home if they’re able to do so. It is widely acknowledged that for every 10 days in a hospital, an elderly patient can experience up to 10 years of muscle deterioration. So our Discharge to Assess service ensures patients are safely supported in their own home environment. It works with people to improve their independence after a stay in a hospital. For example, some patients may need stairs assessment, but people tend to have significantly more confidence traversing the stairs in their own home, as opposed to a hospital environment. By assessing patients in their own home setting, we are able to truly see what help they need to remain independent. Over 700 Lincolnshire patients have received support at home from Discharge to Assess, and in 2023 we will keep growing the service aiming to provide over 100 visits a day.

The pandemic has taught us that we can support patients remotely by using technology. In Lincolnshire, LCHS staff work on several virtual wards specialising in different conditions. We have virtual wards for cardiac, frailty, respiratory, children’s complex neurology and same-day emergency care. They offer hospital-level care and remote monitoring for patients who would otherwise be in a hospital by preventing admissions or allowing them to return home sooner to continue their treatment at home. This is an innovative approach which is delivering high quality care, safely and conveniently. This year our cardiac, frailty and respiratory virtual wards have cared for nearly 600 patients.

So as you can see, there is a lot going on in our services. I haven’t even mentioned many of our services that people of Lincolnshire regularly interact with, including community nursing, Urgent Treatment Centres, vaccination centres, adult and children’s therapy services. The list is too long to give a shout-out to everyone.

Although we have a difficult winter ahead, in 2023 LCHS has more exciting developments. For now, I’m sending everyone best wishes for the festive season and a healthy New Year.

Maz Fosh,

Chief Executive at Lincolnshire Community Health Services NHS Trust