NHS North Norfolk CCGGoverning Body in Public

Patient Story May 19th 2015

Mr X

This story tells the recent experience of a real North

Norfolk patient

o Mr X is 93 and lives with Osteoarthritiso He lives at home with his wifeo They have other family that live nearby

and supports them

1. Mrs X recently had a stroke2. Mr X visited her in the NNUH everyday3. Journeys made his knee painful4. He lost some mobility which made it harder to

cope at home5. Family asked practice to confirm what was wrong6. Same day GP medical assessment concluded

existing osteoarthritis – no acute nursing or medical needs

What changed for Mr X?

What happened next?1. Family asked for some help from social

services to find self-funded respite care2. Family told they didn’t fit the criteria 3. Issue was considered ‘a medical problem’4. Mr X spent 2 weeks in Kelling5. He couldn’t visit his wife6. His discharge summary stated:

1. No medical intervention2. Self-caring on the ward

In future…..What experience would we like to see for Mr X

in future?Mr X or his family calls a number on a magnet

stuck to his fridgeThis goes to an Integrated hubThe right services and care co-ordination is

switched on e.g.: Increased care package in own homeOrRespite care in a residential setting

What have we learnt from this?

• Systems aren’t quite as good as we thought: – people are still slipping through the gaps– this was a simple problem but without a simple

solution• We will include in the development of the hub

model: – low level support to stay at home– quicker and clearer responses– voluntary sector support