Health and care partnerships in Croydon are helping older residents to regain their independence

Croydon’s health and care partnership – Robert’s story from SWL Health and Care Partnership on Vimeo.

A Croydon man is being helped back on his feet thanks to the local health and care partnership, after spending almost a year in hospital with a catalogue of health problems.

After becoming unwell, Thornton Heath resident Robert Scarlett was admitted to St Helier Hospital in Carshalton with breathing difficulties.

Confined to a hospital bed for almost a year, during which time his wife passed away, Robert was discharged from hospital to his home shortly before Christmas, alone for the first time in 45 years.

78 year old Robert said:

“When I first returned home, I was fearful about what would happen to me as I was on my own for the first time in nearly 50 years. I relied on medication for a number of long-term health conditions and needed visits from carers three times a day.”

Unable to use his stairs without help, he became confined to the top floor of his home, with only an electric heater to keep him warm through the winter. Robert quickly lost weight and began suffering panic attacks, for which he needed regular medication.

But everything changed for Robert when Brigstock Road Medical Practice referred him to Age UK Croydon’s personal independence co-ordinator Sylvarani.

Working with partners from across the health service, the council and the voluntary sector, Sylvarani arranged for heating to be installed in Robert’s home, helped him apply for financial support and set him small, achievable targets to develop independence in his own home, such as walking up and down the stairs once a week.

Robert continued:

“Thanks to Sylvarani and the team of people supporting me, I can move around more and cook my own meals, which has helped me gain some weight. I’m even getting up and down the stairs a few times a day and have been working with my doctor, so I’m well enough to start driving again. And I’ve not been back in hospital since! I’m so much more confident now and it’s all thanks to the support I received.”

Thanks to One Croydon – the partnership between local NHS services, GP practices, Croydon Council and Age UK Croydon, 18 personal independence co-ordinators are helping to deliver co-ordinated support for older people living in the borough.

The scheme is just one of the many ways that South West London’s Health and Care Partnership is bringing together local organisations providing health and care in six London boroughs – acting as one team to keep people healthy and well in Croydon, Sutton, Kingston & Richmond, and Merton & Wandsworth.

Dr Dev Malhotra, GP at Brigstock Road Medical Practice – the first GP surgery to adopt the scheme – said:

“We know that people’s care is better when organisations work closely together to provide health and social care, physical and mental health.

“As a GP, I’m able to help people manage their physical health – but it’s only in the last year that we’ve been able to work in partnership to look more holistically at people’s overall wellbeing, through an integrated ‘huddle’ meeting that brings together local health and social care organisations.

“There are so many other factors in keeping people well that are just as important as traditional health services – like the house you live in, how warm it is, whether people feel isolated or alone, the food they eat every day, how mobile and independent people are.

“By taking care of Robert’s immediate health needs, as well as his wellbeing, we’re strengthening our focus on keeping people well – and out of hospital.”

Dr Agnelo Fernandez, Croydon CCG GP Chair said:

“Working together in partnership, the NHS, Croydon Council and Age UK Croydon are sharing their knowledge of communities, and their resources, to make a huge difference to the lives of people like Robert. In this way, we can support people’s health and social needs as part of one team.

“We are working together in new ways across our organisational boundaries, acting as one team, to keep people healthy and give local people better care when they are ill.

“As part of our health and care partnership in Croydon – and across south west London – we want to roll out more of this kind of partnership work so we can make care better for people across all six boroughs.”

Kate Pierpoint, Chief Executive at Age UK Croydon said:

“Age UK Croydon is pleased to be a delivery partner in this innovative approach to supporting older people to retain their independence and maintain a good quality of life.

“The Personal Independence Coordinators as part of Croydon’s New Model of Care, are driving preventative, holistic, people-centred care. The PIC team work alongside health and care professionals, adopting a multidisciplinary approach to working with older people who have long term health and social care needs.

“Most importantly, they ensure that care planning is influenced by the wishes identified by individuals, so that independence can be either improved or maintained.”

Councillor Louisa Woodley, Croydon Council’s cabinet member for families, health and social care, said:

“The One Croydon alliance makes better use of professionals’ resources so Croydon residents can manage their conditions better and do more of what they love.

“Successes so far have included 62% fewer patients needing care packages for longer than six weeks after leaving hospital, and everyone in the One Croydon alliance will continue to work together so we get better results for our residents.”

Watch Robert’s full story now: