Upskilling Health and Care Workers to Provide Additional Capacity in the Community - A Service Evaluation of the Nefyn Pilot (Final Report)

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Abstract

The Welsh Institute for Health and Social Care, University of South Wales (USW) and PRIME Centre Wales (at USW) were commissioned to undertake a service evaluation of the Nefyn pilot.

Situated within the Tŷ Doctor Practice on the north-west coast of the Llŷn Peninsula, the Nefyn pilot is trialling an approach to upskill health and care workers to provide additional capacity in the community.

The pilot project came about of necessity during the early stages of the COVID-19 pandemic. Initially it was a partnership between the lead GP at Tŷ Doctor and home care provider Gofal Seibiant to upskill home care workers to undertake basic observations with patients within their own homes. The purpose of this was that it would offset the need for the GP to make additional house calls at a time when the NHS was experiencing acute capacity issues. Skills training included:
- Pulse
- Pulse oximetry
- Blood pressure
- Temperature

The Nefyn pilot put in place a structured five-step process. The home care workers within the pilot were not expected to make any clinical decisions but to facilitate observations. During the pilot, it has always remained the role of the clinician to make decisions about what treatment may or may not be required.

The process operated as follows:
1. A patient is assessed by telephone triage.
2. The GP rings the worker on their mobile phone.
3. They discuss which observations are required.
4. The worker travels to the house, undertakes the observations and calls the GP back.
5. This facilitates a face-to-face consultation on a widely available video consultation platform.

Since commencing, the Nefyn pilot has evolved from Tŷ Doctor working with the care provider to upskill home care workers to upskilling its own healthcare workers within the practice, which is facilitated by the Integrated Care Fund and GP cluster funds.

This report presents findings from the service evaluation, a small pilot study focussed on capturing learning from the design, implementation and ongoing delivery of the pilot model to inform those across North Wales (and elsewhere) should this model be rolled out more broadly.
Original languageEnglish
PublisherWelsh Institute for Health and Social Care
Number of pages22
Publication statusPublished - Jul 2021

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