Community services for care homes

Diabetes

Details not yet available.

Podiatry (SCFT)

The service is available to eligible patients, with a high degree of podiatric need and underlying risk factors, on an individual basis where podiatry is not already supplied as part of the homes charged for package of care.

All patients are assessed using standard assessment criteria and those with low podiatric need and no underlying conditions placing the foot at risk will not rate sufficiently highly to be registered with the service.

The service will not accept referrals for footcare (ie toenail cutting and skin care) where no underlying medical condition warrants such an intervention.

Referral pathway

The podiatry service will accept referrals from GPs, and other healthcare professionals. The service is clinic based and will only accept referrals for assessment for domiciliary care if the patient is unable to attend clinic by any other means.

Proactive Care (SCFT)

Proactive Care is a multi-disciplinary team (MDT) approach to case management which seeks not only to ensure that planned care is well coordinated and comprehensive but that predictable risks associated with the patient’s wellbeing are identified and planned for. The improved patient experience will include the reduction of unplanned admissions.

The MDT consists of community nursing, social workers, OTs, Physios, Community Pharmacists, Mental Health Nurses and support workers as well as primary care colleagues including the GP.

Patients who are frail or otherwise at risk of deteriorating care and who would benefit from a MDT approach to care planning and delivery can be referred to the Proactive Care Team via OneCall (see below).

Referral pathway