A specialist team at Black Country Healthcare NHS Foundation Trust is providing bespoke support for some of the most vulnerable people in our communities, helping them to receive the care they need to lead happier and healthier lives.
The High Intensity Use Service (HIUS) at BCHFT provides support to patients who have complex health, social and psychological needs. It is targeted at people who have attended the Emergency Department at New Cross Hospital ten or more times in 12 months or more than three times in one month.
The most deprived communities and inclusion health groups are disproportionately over represented by those accessing emergency services in high volume, so the team play a vital role in supporting people who are most at risk of health inequalities and deprivation within the community, for example people experiencing mental illness, homelessness, drug and alcohol dependence, vulnerable migrants, people in contact with the justice system and other socially excluded groups.
The HIUS work collaboratively with local health and social care systems to promote a positive and fresh perspective for patients, focusing on addressing the unmet needs of the patient group with a personalised approach by supporting and empowering them to access appropriate services and healthcare. The team provide hospital in-reach and coordination, community outreach and attendance at multi-agency meetings and advocate patient’s needs at multi-professional meetings and ward reviews.
HIUS support has a focus on wider determinants of health and work with individuals to overcome issues in their life such as loneliness, significant life changes such as bereavements, relationship breakdown, or trauma often combined with the challenge of social and economic deprivation. HIUS offer time and emotional support that is primarily non-medical and can range from helping people to access community groups, accompanying them to appointments and helping them to build connections and relationships.
Their work is helping to create a better understanding of the patient group and the difficulties they face.
Melanie Lamb, clinical lead at the HIUS, explained: “People who frequently attend Emergency Departments can be misunderstood and are often associated with the stigma that can lead to further exclusion from society.
“HIUS is always a non-punitive approach, we never tell patients not to attend the hospital or call 999 for support. Instead we focus on uncovering the underlying reasons for attendance, and work with them to overcome these issues.”
As well as boosting the quality of life for their patients, the service has led to a reduction in the number emergency department attendances among those supported by HIUS.
Thanks to the work of the HIUS, there was a 60% reduction in Emergency Department attendances and non elective admissions to New Cross Hospital among patients under the care of the team from pre to post referral to the service during 2022/23.
Individuals who have been supported by the HIUS are going on to thrive in their communities, from being able to enter employment and volunteering to having more confidence to pursue interests and better relationships.
The impact the service continues to make can be seen in the feedback from a service user who simply said: “Before you helped me I was just existing, now I'm living.”