OPERATE study 0001

• Research type

  Research Study

• Full title

  Can a highly integrated, urgent care pathway for older people featuring ‘early-in-day’ GP home visit, shared patient records, and single points of contact between primary, secondary, and intermediate care in a locality reduce unplanned admissions (number and bed days) and provide higher quality care compared to other developing locality systems without the pathway?

• IRAS ID

  218852

• Contact name

  David Attwood

• Contact email

  davidattwood@nhs.net

• Sponsor organisation

  Torbay and South Devon NHS Foundation Trust

• Duration of Study in the UK

  0 years, 11 months, 30 days

• Research summary

  Advances in healthcare have seen an improved life expectancy. However this has come at a price, with a rising number of unplanned admissions (UPA), particularly in housebound, frail, elderly patients.

  Several problems affect their care:
  1. When frail, elderly patients become unwell, they need a medical evaluation and multi-disciplinary team (MDT) assessment.
  2. The divide and delay between primary, secondary, and intermediate/community care.

  The NHS Five year Forward View and Devon Sustainability and Development Plan (STP) suggest that integration of primary, secondary, and community care sectors could offer a solution. However, no country has achieved three-sector integration.
  The Newton Abbot locality (South Devon) is undertaking a study assessing the implementation of three-sector integration using a new care pathway called the Older Persons Rapid Assessment and Treatment (OPERATE) pathway. OPERATE is activated when an over 65 year old, unwell patient contacts their doctor’s surgery to request a home visit. If appropriate, they are referred to an urgent home visiting service.
  Following medical evaluation, the case will be either managed in intermediate care or referred to secondary care. Referrals and handovers will occur by phone, rather than forms.

  The study will take place across 7 practices in the Newton Abbot Locality of South Devon and last for one year. Primary outcome measures will include:
  1. Number of over 65 year olds admitted and number of unplanned bed days per month
  2. Patient and staff satisfaction using interviews
  3. Various efficiency markers

  Results will be compared to the other 5 localities in the South Devon area which will not have the care pathway.

• REC name

  West Midlands - Edgbaston Research Ethics Committee

• REC reference

  17/WM/0201

• Date of REC Opinion

  7 Jun 2017

• REC opinion

  Further Information Favourable Opinion