Service user experiences of CNWL services: part 2: Rapid Response

Camden Clinical Commissioning Group asked Healthwatch Camden to conduct service user research around two newly commissioned services: Discharge to Assess and Rapid Response. Rapid Response aims to reduce visits to A+E and hospital admissions by providing rapid short term care and support for the patient at home after an incident that may otherwise lead to a hospital visit. Rapid Response can also be deployed after discharge from hospital to provide short term support with the aim of avoiding re-admission.

Key findings

All those interviewed were clear that they wanted to remain at home and were pleased that the Rapid Response team allowed them to do so. No one expressed anxiety at being encouraged to stay at home rather than go to hospital. 

The majority of those interviewed felt they benefitted from the support at home.  Most patients had support needs that linked them into a wide range of medical or care services making it hard to identify feedback related to the Rapid Response service in isolation. In cases where patients were in contact with a range of different services the feedback was less positive. 

Generally there was positive feedback about Rapid Response team personnel. There were some cases of failure to follow up on commitments made to patients and actions that appeared to have been lost in the transition between teams. 

Many patients expressed some confusion around managing the complexity of their care needs and different appointments. Patients were frequently assisted by family members and carers which sometimes confused the picture. Ill health or injury made many patients feel dependent and lacking in control. This lack of agency played out in different ways for each patient. 

Several patients expressed conflict around a desire to retain independence while needing support. In some cases this led patients to refuse support that was offered. 

Very few patients reported a “seamless service”. Only three patients reported having “no idea” who was meant to be doing what. But only five reported a full understanding. The sense of not being able to comprehend who is meant to be doing what causes stress. 

Patients expressed a preference for having a single named person and telephone number they knew they could contact if any aspects of their support and care did not go smoothly. 

Patients want good communication — both with them and between the individuals caring for them.