As the pressures of winter and the Covid treatment backlog grow, the NHS is struggling. In Manchester, one organisation is pioneering a new way to care for people that tries to reduce the burden on the health service.
It's the first call-out of the day for nurse Manju and pharmacist Kara in north Manchester. They are on their way to see Steven, who has been diagnosed with Parkinson's disease and had a fall the previous night.
This might have led to a call-out for an ambulance crew and a visit to A&E. But instead the Manchester Local Care Organisation (LCO) stepped in.
Once at Steven's house, Manju makes sure he hasn't been harmed by his fall, while Kara checks his medication.
Manju notes that Steven's tablets could have contributed to his fall.
Manju asks Steven how he copes going up and down the stairs.
"I'm OK, just about," he says. But when he has a go at coming down the stairs, Manju spots he could use an extra grab rail and says she will sort one out.
This intervention by the team has not only avoided Steven ending up in A&E, but also ensures he can continue to live independently in his own home.
That's a key part of the LCO mission, according to Lana McEwan, one of the team leaders in north Manchester.
"We would consider ourselves to be an admission-avoidance service, so we're trying to prevent ambulances being called in the first instance.
"When an ambulance has been called, we're taking referrals directly from the ambulance service and responding within a one or two-hour response depending on need, and that's an alternative to A&E."
Local neighbourhood teams are made up of nurses, social workers, pharmacists and doctors, all working together to keep people out of hospital.
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Source: BBC News, 9 December 2022