Consultation Terminology
Care Homes
Care homes can be categorised as either residential or nursing. Residential homes provide
help with personal care only, whilst nursing homes also provide nursing care and must have
a qualified nurse on duty at all times.
Clinical Commissioning Group (CCG)
Clinical Commissioning Groups (CCGs) are NHS organisations set up by the Health and
Social Care Act 2012 to organise the delivery of NHS services in England. They commission
most of the hospital and community NHS services in the local areas for which they are
responsible. Commissioning involves deciding what services are needed and ensuring they
are provided. CCGs are overseen by NHS England which retains responsibility for
commissioning primary care services such as GP and dental services as well as some
specialised hospital services.1
South Devon and Torbay CCG is responsible for planning, designing and buying healthcare
services for its local population.
Clinical Hubs
In each locality there would be a clinical hub providing people with better access to medical,
clinical and specialist services. A clinical hub would offer a broad range of services to
people and although one would be provided in each locality, they could be used by
everybody irrespective of where people live.
The clinical hubs would offer services such as outpatient appointments and specialist
conditions clinics and inpatient services. By bringing services together in a single location
we would reduce the need for people to travel to Torbay hospital for their services, therefore
adopting the principle of ‘care closer to home’. The clinical hubs would be provided in
buildings that are of a high clinical standard and where necessary additional investment
would be made to improve the quality of environment and range of services offered.
Community Clinics
These would operate in health and wellbeing centres. They generally have more than 1,000
attendances a year and are mainly provided by locally based professionals, working across
community sites. Examples of community clinics include MSK (Musculoskeletal assessment
and treatment), speech and language therapy, podiatry.
Domiciliary Care/Personal Care Services
1
NHS Choices website www.nhs.uk
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Home-based personal care, usually on a long-term basis, provided by a private agency,
regulated by the Care Quality Commission. These agencies help a service user stay safe
and well in their own home. Support may include help with washing and dressing, meal
preparation or prompting someone to take their medication. These are vital services to help
more people to live independently at home for longer without the need for residential care or
a stay in hospital. Support workers working for a personal care agency are not healthcare
professionals and are not able to provide nursing support.
Local personal care services are commissioned by Torbay Council and Devon County
Council in partnership with Torbay and South Devon NHS Foundation Trust and the CCG.
Health and Wellbeing Centres
There would be a Local Health and Wellbeing Centre in Ashburton/Buckfastleigh, Bovey
Tracey/Chudleigh, Brixham, Dartmouth, Newton Abbot, Paignton, Totnes and Torquay.
These would see community staff based locally and working alongside GP’s, pharmacists
and voluntary sector organisations to provide health and wellbeing services to the area.
Some Health and Wellbeing Centres would be located as part of the Clinical Hub.
Health and Wellbeing Teams
These teams would bring together in each locality an integrated team of community health
and social care staff, mental health professionals and our voluntary sector partners to
organise and deliver most of the health and social care needs of the population. They would
work as a bridge between their GP services and the very specialist care that can only be
provided in a large hospital like Torbay.
Integrated Care Organisation (ICO)
The single organisation responsible for acute and community healthcare in our area, known
as Torbay and South Devon NHS Foundation Trust. It also provides social care for adults in
Torbay.
Intermediate Care
A range of integrated services provided for a limited period of time to people who need extra
support and care following a period of ill health. The emphasis of intermediate care is on
active enablement.
The aim of the intermediate care service is to:
 Support people at home when safe and appropriate to do so and thereby reducing
admissions to hospital, reducing inpatient lengths of stay and reducing readmissions.
 Adopt a person-centred approach in which the individual takes on an active role to
achieve maximum independence and quality of life. The intermediate care team
supports the individual to set achievable objectives to help them attain their long term
goals.
Wherever possible the service will support people to remain at home throughout their
episode of intermediate care. However, where this is not possible, a short-term care home
placement is used to support the person and enable them to return home again, usually
within twelve days. Placements are currently made to contracted homes, ideally located as
close to the person’s home as possible.
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Enhanced Intermediate Care is built on the existing service model of intermediate care but
enhanced and extended to ensure that it’s able to be responsive to increased referrals. It
includes additional medical and pharmaceutical input to support better outcomes for the
patient.
Long Term Condition
A condition that lasts longer than a year, impacts on a person’s life and may require ongoing
care and support. Examples include diabetes, asthma, arthritis and chronic obstructive
pulmonary disease (COPD). Long term conditions become more prevalent with age and
older people are more likely to have more than one long term condition. Where a person
develops more than one long term condition they are described as having multiple long
term conditions.
Lower Layer Super output Area (LSOA)
LSOAs are geographic areas used by the Office of National Statistics (ONS) for census data
and are areas that consist of between 1,000 and 3,000 people or 400 to 1,200 households.
Multi Long Term Conditions Clinics
These would provide a ‘one stop shop’ approach to help people manage multiple long term
conditions by accessing information and treatment in a single clinic.
Minor Injury Units
MIUs provide a local urgent care service in the community, filling a gap between GP
services, the 111 service and A&E. They are intended to reduce unnecessary travel to the
emergency department for non-life threatening injuries. Minor injuries units are an important
part of the urgent care services by treating people with for example minor burns, sprains and
fractured bones.
Primary Care
The health care and treatment given by a health provider who typically acts as the principle
point of consultation for patients within the healthcare system and coordinates care with
other specialists that the patient may need. This care is most often given by a patient’s
General Practitioner (GP)
Secondary Care
Healthcare services provided by medical specialists and other healthcare professionals who
generally do not have the first contact with the patient. Usually secondary care services are
provided in an acute general hospital such as Torbay Hospital.
Self-Care
Personal health maintenance. Any activity of an individual, family or community, with the
intention of improving or restoring health, treating or preventing disease or maintaining
existing good health.
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Single Point of Contact (SPOC)
A multi-media gateway to provide information and to mobilise relevant assessments and
resources. Public and professionals will have a single point of entry into services across
South Devon and Torbay with prompt and customer focused responses and minimal
handover.
The SPOC will divert activity away from statutory services, providing information and
signposting to support self-care.
Specialist outpatient clinics
These would operate in clinical hubs and are clinics where patients currently travel further to
access them. They would be mainly consultant-led and usually have less than 1,000
attendances a year. Some non-consultant-led clinics such as audiology require more
specialist facilities or equipment.
Examples of specialist outpatients might include: audiology, cardiology, dermatology, ear
nose and throat, endocrinology, general medicine, general surgery, gynaecology, neurology,
orthopaedics, paediatrics, rheumatology and urology.
Torbay and South Devon NHS Foundation Trust (TDSFT)
Torbay and South Devon NHS Foundation Trust was formed on 1 October 2015 through the
acquisition by South Devon Healthcare NHS Foundation Trust of Torbay and South Devon
Health and Care NHS Trust, creating an Integrated Care Organisation (ICO). This one
organisation now provides acute care from Torbay Hospital and community services through
a network of community hospitals, bases and people’s homes and adult social care.
Wellbeing Coordinators
Wellbeing Coordinators would work closely with health and wellbeing teams and GP
practices. They are employed by local voluntary organisations and connect people with the
many activities and community groups that are available to address social isolation and help
a person to maximise their independence. A strengths-based approach to practice will utilise
guided conversations and self-management support tools.
Bed Definitions
Rehabilitation Beds: Beds for those recovering from a severe illness, who need to recover
their health and mobility before going home, or for people who would be at risk if left at home
and would benefit from rehabilitation care. Rehabilitation services are led by physiotherapists
and occupational therapists providing intensive support with nursing and medical input as
required.
Intermediate Care Beds: The proposed new model of care outlines a proposal for
investment in intermediate care, both within people’s own homes and dedicated beds within
local care homes. These will need to be procured within regulatory guidelines.
Intermediate care services may be provided as step-up beds (intermediate care provided to
a patient at home or in a care home as an alternative to admission to hospital) or step-down
beds (intermediate care provided to a patient at home or in a care home following discharge
from hospital).
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Community Medical Beds: Beds for patients who need intensive, expert nursing care
around the clock with medical input where needed, but who do not need the more intensive
care and facilities of an acute hospital. They are also for patients who have been referred to
the hospital by their local GP because they require medical or nursing input that cannot be
provided in their own home or a local care home.
Acute Care Beds: Acute care beds are beds accommodating patients where the principle
clinical intent is to do one or more of the following:
-
Cure illness or provide definitive treatment of injury
Perform surgery
Manage labour (obstetric)
Relieve symptoms of illness or injury (excluding palliative care)
Reduce severity of illness or injury
Protect against exacerbation and/or complications of an illness and/or injury which
could threaten life or normal functions
Perform diagnostic or therapeutic procedures
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