Health and Social Care
The demand for health and social care is rising as a result of an increase in the number of people with chronic long term and often complex conditions alongside an ageing population. The NHS Five Year Forward View highlights the need for an increased focus on integration and prevention so that resources are utilised more effectively, outcomes are improved and demand is reduced. The NHS is estimated to require £30 billion over the next five years, with an estimated £17.9 billion required just for treating ‘risky’. It is estimated that up to 30% of hospital beds are currently occupied by patients requiring social care or enhanced home support.

The alignment of risk and behaviours has led us to develop schemes that seek to achieve a sustainable behaviour change in vulnerable clients, and can include issues such as: multi-morbidity, cognitive impairment, smoking, drugs, alcohol, physical inactivity, obesity, loneliness, mental health and cold homes.

The Future
In the NHS 250,000 people attend Accident and Emergency every year as a result of falls. Older people use three and half times the amount of hospital care of those under the age of 65, and almost two-thirds of general and acute hospital beds. The risk of somebody over the age of 65 dying in a fire is more than twice as high as the general population.

Across the UK, the Fire Service provide 670,000 Safe and Well home visits each year and are a valuable opportunity to engage with the most vulnerable in society. The joint development with NHS England and other key stakeholders linked to national policy based on current and emerging evidence and examples of best practice support this new way of working. The planned investment strategy from the NHS across the UK will help transform care through partnerhip working, achieving better outcomes for local people and better value for the money spent on public services.

When 87 year-old Mrs. V fell over in Coventry Market and was admitted to hospital, medical staff were unable to contact her family to ensure a safe discharge – at the same time there was no clinical reason to admit her.

Instead, she was discharged with pain relief, but with the additional control measure of a visit from our crews 10 minutes after her arrival home. On arrival, firefighters found Mrs. V was agitated and uncomfortable, wanting to contact her family, and also unsure how to take her pain killers.

Crews helped Mrs. V with her mobile phone so that she could call her son, and wrote the medicine schedule in her notice book which she used to help her rmember things. Advice was also given to take the documentation with her for her visit to her GP on the following Monday, but if her pain got worse to contact 111.

Following the encounter Mrs. V was left feeling comfortable and willing to talk through her concerns. In addition, her family were happy with our actions, and a feedback report was instant given through our Fire Control team.

The initial information we received about Mrs. P was that she was an 85 year-old lady that had been discharged from hospital and had dementia. On arrival at the agreed time of one hour from her discharge, crews entered through the back door which had been left open and unsecured where they found her lying on the floor.

Unfortunately Mrs. P was unable to get up, and was also very cold. Worryingly, her front room fire had also been left on full. Unaware of her visit or what had happened since she got home, Mrs. P was given reassurance and made comfortable by moving her to the front room following an assessment for injuries.

As Mrs. P was still very confused and with little mobility, Mrs. P was taken back to hospital via an ambulance. Crews also completed a report recommending a joint visit with a care worker and Vulnerable Persons Officer, a falls assessment to be completed and for Telecare equipment to be installed.

Despite being a a failed discharge, we provided a control measure which worked and ensure the safety of Mrs. P through a timely response. This allows for greater confidence in future discharges, knowing that a guaranteed visit will take place in the home environment in a timely manner.

West Midlands Fire Service is a unique and trusted brand that operates across the West Midlands delivering 24/7, 365 responsive services. We recognise the link between the need to keep local people safe from harm and the impact from poverty, deprivation and health inequalities. Operating from 38 stations across the West Midlands, we have the infrastructure to enable us to understand and meet the current and future needs of our changing community. Because the wider public recognises and trusts that we will be there for them and keep them safe from harm, we can use that trust to tackle other issues too.

We understand that to reach the maximum social value in our activities we need to map and tackle health inequalities. This endeavour has been acknowledged by different organisations, and we are one of the first fire services in the country to acquire Marmot partnership status. We work in partnership with other organisations to reduce preventable ill health and early death by targeting through an evidence-based approach demographic groups and areas that are vulnerable within our society.

Uniquely, we provide an enhanced service through the introduction of Vulnerable Persons Officers (VPOs.) These Officers have received advanced specialist training and visit the home, often in partnership with other agencies, after receiving referrals from other organisations, following an emergency incident or a ‘Safe and Well’ visit. They gain the trust and cooperation of a client over an extended period and will continue to visit until they believe the householder is safe from harm.

By working in partnership they can resolve a wide range of problems such as: slips, trips and falls, hearing and sight issues and mobility concerns. By taking the time to deal with a range of issues, they help to ensure that those with special needs or complex conditions receive timely help and support, thereby helping them to retain their independence within a safe environment.

We are currently commissioned to deliver health and wellbeing interventions including slips, trips and falls and achieving the safe discharge of patients from Accident and Emergency and in-hospital stays through our ‘Safe and Well’ home visits and social prescribing. The holistic approach that we’re undertaking places us as a credible service provider for health and local authority commissions.