Before April 2022, around 360 older persons living in residential aged care facilities (RACFs) were transported by ambulance to a Western Sydney hospital emergency department (ED) each month to receive medical care. This placed significant strain on EDs and NSW Ambulance resources, in some circumstances affecting patients’ care experiences and increasing risks to their wellbeing.
To address this challenge, the Western Sydney Local Health District (WSLHD) partnered with NSW Ambulance, general practitioners (GPs) and 65 RACFs across NSW to create the inTouch Residential Aged Care Facility Pathway. It includes the inTouch Urgent Care Service, which gives patients with non-life-threatening health conditions access to a comprehensive health assessment via video calls and direct support from GPs and aged care staff.
This collaborative, patient-focused service enables people to remain in their homes while receiving responsive, high-quality medical care. Between 1 April 2022 and 31 March 2023, the service enabled WSLHD to avoid sending 981 patients to EDs. This an overall avoidance rate of 31%.
How the program works
- inTouch is a single point of contact for RACF staff and GPs with residents who have acute health care concerns and needs that exceed the capability of the GP and RACF to manage independently.
- Clinical advice is provided via telephone or video by inTouch nurses and doctors, with direct access to specialist advice as needed.
- Following assessment, patients can be referred to a wide range of providers in different care settings, such as Hospital in Home, community response teams, and other community-based treatment and escalation services.
- RACFs have mobile diagnostics capability for rapid assessment and treatment.
- A shared care plan is developed in partnership with patients/carers and providers. The pathway supports urgent care by finding real-time alternative care pathways and connecting GPs to the extended care team.
- The inTouch team monitors NSW Ambulance cases and coordinates with RACFs to identify alternative care options for low-acuity patients.
Increasing care options
The inTouch Residential Aged Care Pathway has expanded at-risk residents’ care options in an efficient and accessible way. About 3,131 referrals for residents living in 71 RACFs within WSLHD were made to 31 March 2023.
Through collaboration, the service has fundamentally changed the way WSLHD cares for one of its most vulnerable communities. This model of care is scalable across NSW Health and has been granted 2 years’ funding as part of the Urgent Care Services in NSW initiative, which commenced in July 2023.