How Mid and South Essex Health Care Partnership have reduced ambulance callouts to care homes by 69%
Case Study at a Glance
Mid and South Essex (MSE) Health Care Partnership (HCP) were experiencing high volumes of ambulance callouts to non-injury falls. The average ambulance response time to non-injury falls was 4 hours or more, resulting in long lies that led to avoidable hospital admissions.
They issued Raizer Lifting Chairs to care homes within their region to enable the care home staff to lift non-injured fallen residents. This improved the quality of care that the homes could give their residents, and reduced the number of ambulance callouts by 69% – resulting in significant financial savings.
The Headline Stats*
There are 320 Care Homes in the Mid and South Essex Commissioning Area
*These statistics are covered in more detail in Section 7: The Cost Savings
The Challenge: Too Many Ambulance Callouts and Long Lies
Non-injury falls result in avoidable ambulance call outs. It’s estimated that 1,000 care home residents in the UK will fall every day, of which 45% are uninjured and do not require conveyance to hospital1. And the average ambulance response time to an uninjured faller (category 4) in October 2021 was 3 hours – against a target of 1 hour 30 minutes2.
Without appropriate patient lifting equipment, care homes would call the ambulance service to respond to falls. The traditional approach of using a hoist and sling to lift a resident from the floor is difficult in the confined spaces of a care home and can be distressing for the resident, particularly if they are living with dementia.
Ambulance response times for non-urgent calls resulted in residents who had fallen experiencing long lies. A long lie puts the fallen person at high risk of complications like pressure ulcers and rhabdomyolysis. A resident who is admitted following a fall and a long lie is put at high risk of deconditioning, so they will then be discharged with more complex needs.
As a result, non-injury falls were absorbing significant capacity across acute services. Ambulance callouts to non-injury falls increase response times to urgent category 1 and 2 calls, and conveyances from care homes increase ambulance handover delays, adversely impacting the number of people that A&E could see within their 4 hour target time.
The Full Case Study Video
The Solution: Issuing Raizer Chairs into Care Homes to Lift Fallen Residents Themselves
Finding the Solution
Mid and South Essex Health and Care Partnership (MSE HCP) looked at how they could reduce ambulance callouts to non-injury falls in care homes. They then identified an assessment tool to enable care home staff to ascertain whether a fallen resident was safe to be lifted from the floor.
MSE then carried out an options appraisal on falls lifting equipment. They chose the Raizer Lifting Chair because it is easy to assemble and safely lifts the fallen resident from the floor in a smooth motion.
“The reason why I like the Raizer Chair is because you build it around the fallen person. It doesn’t involve having to move the fallen person too much to be able to put them on it”
Matt Gillam
Head of Nursing at Southeast Essex CCG
Felgains then worked with MSE to identify what we were trying to achieve with the project, and supported them with a pilot of 70 Raizer Lifting Chairs.
What is the Raizer?The Raizer is a motorised lifting chair that assembles around a fallen person and lifts them up to a seated or perching position. It is easy to assemble and use for the caregiver, and it is safe, smooth and very reassuring for the fallen person.
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Implementation
To maximise the success of the pilot, Felgains delivered a 45 minute personalised face to face training session in every care home to a selected Raizer champion, who then then cascaded the training to all their staff. To support this, we also created a bespoke Raizer training video that explained: what the Raizer Lifting chair is; why the care home had been given a Raizer; and how to operate the Raizer lifting chair.
This train the trainer approach allowed the care home staff to fit the training in with their clinical duties and reduced the number of questions being fed back to both Felgains and the ICS. You can see some snippets of this video here.
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“We’ve done this pilot scheme in partnership with Felgains, who have supported us with the training videos. Also the data monitoring has been supported by them, they’ve been really helpful”
Matt Gillam
Head of Nursing at Southeast Essex CCG
The Clinical Impact and Results: Reduced Ambulance Callouts to the Care Homes, and Improved Care in the Care Homes
Reduced Ambulance Callouts
Over the 6 week pilot, the 48 of the 60 participating care homes that we could record data for achieved a 69% reduction in ambulance callouts. This freed up the ambulance service to improve response times to category 1 and 2 callouts and reduce handover delays.
Enhanced Health in the Care Homes
Care home staff are able to respond much quicker to fallen residents. Staff morale has improved, as they are feeling much more empowered and confident in their ability to self-sufficiently respond to falls. Avoiding long lies has reduced the risk of harm to residents, protecting their wellbeing in the community.
The stable supportive lift of the Raizer Chair minimises distress and the risk of injury to both residents and staff
Adalah, Leigh-On-Sea
“Our 111 calls have decreased by 100% since we’ve had the Raizer chair. We haven’t needed to call them since. That chair is absolutely invaluable -and we can’t manage without it now. There is just so much calmness now around the residents -they actually enjoy using it!! We’ve had one or two falls which other residents have then witnessed us using the Raizer, and they have asked if they can have a go!“
Jennifer Read, Manager at the Adalah
Leatherland Lodge, South Ockenden
“I would like to say thank you, a very big thank you. It’s been amazing! it’s made a change in my home, it’s reduced my paramedics call outs. The way forward is technology and the Raizer Chair to a resident compared to a hoist and sling – it’s less daunting, less frightening for them and they feel more relaxed and more comfortable. And at the end of the day it’s about keeping your resident happy and as comfortable as you can”
Kerry Cooper, Manager at Leatherland Lodge
Southend Care
“since we started using the Raizer Chair, we have found that month on month for the past eight months we have had a reduction in calling the emergency services. Before we had the Raizer chair, we were calling out the ambulance service probably about five times a month. However, now that we have the Raizer Chair, we’ve noted that calling on the ambulance services and taking an ambulance out of the emergency role is probably down to once every other month.”
John Mills, Clinical Lead at Southend Care
Delivering Integrated Care
The success of this project has both assisted and vindicated Mid and South Essex HCP’s move towards integrated care. Cross sector working and engagement to implement the Raizer Lifting Chairs into care homes has delivered better care and performance across the ICS and, importantly, improved patient care.
Urgent Community Response Team
In addition to the Care Homes, MSE also supplied the Urgent Community Response Team with Raizers to enable them to respond to falls in the community. Read the separate case study here to find out more about how they are preventing 15 ambulance callouts every week.
The Cost Savings
The Pilot
Within just 6 weeks, across 48 care homes, there was a 69% reduction in ambulance callouts.
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Total falls in 48 care homes over 6 weeks |
244 falls |
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Self-stand |
52 times |
21% |
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Ambulance callout |
42 times |
17% |
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Raizer used |
150 times |
62% |
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National average for an ambulance callout after a fall |
45% |
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Number of callouts before the Raizer if applied to the MSE Pilot |
134 |
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MSE ambulance callouts during the pilot |
42 |
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MSE ambulance callout average during the pilot |
17% |
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Number of Ambulance callouts avoided (134 – 42) |
92 |
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Percentage reduction in Ambulance callouts |
69% |
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Number of ambulance callouts avoided |
92 |
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Average cost of an ambulance callout in MSE |
£252 |
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Cost saving in avoided ambulance callouts, over 6 weeks (92 x £252) |
£23,184 |
Callouts Saved Per Care Home Per Week
First let’s calculate the number of callouts saved per home per week to give us a base number to work with;
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Number of homes data was received from |
48 |
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Number of callouts saved per home in 6 weeks (92 / 48) |
1.9167 |
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Number of callouts saved per home per week (1.9167 / 6) |
0.3194 |
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Number of callouts saved per home per year (0.3194 x 52 weeks) |
16.088 |
All 320 Mid and South Essex Care Homes over a 12 Month Period
If we then look at projected savings across all 320 care homes in Mid and South Essex over a 12 month period;
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Number of callouts saved per home per year (0.3194 x 52 weeks) |
16.088 |
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Total number of Care Homes in MSE commissioning area |
320 |
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Total number of ambulance callouts saved per year in MSE (16.088 x 320) |
5,314.816 |
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Average cost of an Ambulance callout in MSE |
£252 |
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Total projected saving over a 12 month period in all 320 homes (5314.816 x £252) |
1,399,333.63 |
This means that over a 12 month period in all 320 Care Homes, Mid and South Essex would have a projected saving in Ambulance callouts of over £1.3 million!
Expanding the Raizer Rollout
Following the success of the pilot scheme, MSE are now widening out the project to issue the Raizer into more care homes in their commissioning area.
“We should be moving to a place where supporting our patients in our falls pathways in the communities is everyone’s business across our community services, rather than needing to call the ambulance when someone has fallen”
Ryan Cossington-Webb
Head of Urgent Community Response at MSE
Learnings & Conclusions
By issuing Raizer Lifting Chairs to Care Homes in their Commissioning Area, Mid and South Essex HCP are;
- Reducing ambulance callouts by 69%
- Improving ambulance response time to category 1 and 2 callouts
- Collaborating across public and private services to drive engagement and improve patient outcomes
- Predicting a projected saving of £1,339,333 every 12 months
How to Get Started on Implementing This in Your ICS
Having seen the positive impact that this programme has had across Mid and South Essex, how do you see this benefitting your ICS?
We can work with you to develop a bespoke solution that is tailored to your specific needs and that is guaranteed to significantly reduce ambulance callouts – saving you money whilst improving the care in your commissioning area. We will guide you right from initial concept through to monitoring, reporting and full rollout.
To find out more and get started today, please reach out to one of our experts
And click here to find out more about the Raizer 2 Emergency Lifting Chair
Citations
1: Cardiff University, 2006
2: NHS England Ambulance Quality Indicators, October 2021