A Virtual Clinic was set up at an acute general hospital in the Mid-Essex area with the specific aim to co-ordinate the care of adults diagnosed with intellectual disabilities (ID) coupled with two or more long term conditions.
This is one of the National Institute for Health and Care Excellence (NICE) shared learning case studies. NICE has over 800 examples showing how our guidance and standards can improve local health and social care services.
The virtual service was implemented initially as a work-based project by the Hospital Liaison Nurse (HLN) over an 18-month period between 2017 and 2019. It was designed to keep the patient very much in the centre of their care with regular patient/carer remote contact, ongoing assessment, monitoring, clinical decision making and person-centred care planning. In a consultative capacity, the HLN was enabled to work remotely and maintain ongoing close patient/carer contact, effective case management and improved communication across multiagency professionals. This included ongoing virtual collaborative working across care providers and professionals working within primary, secondary and tertiary health and social care services.
Overtime, by embedding person centred care and coordination into clinical practice; it became clear that the approach of the HLN’s role shifted from reactive to proactive care provision. This was likely due to early recognition and earlier response to the subtle signs of deterioration in the patient condition. The initial findings highlight the potential of virtual care coordination, to essentially respond to the ongoing changing health needs of adults diagnosed with an ID and comorbidities and enable timely planning for the individual’s future longer term needs.
This shared learning example relates to NICE guidance and quality standards: (QS153) on Multimorbidity (Statement 3 on coordination of care and (NG56) Multi-morbidity: clinical assessment and management.
In particular this project takes into account NICE recommendations in relation to equality and diversity considerations and making reasonable adjustments as follows: healthcare professionals should take into account the needs of adults who may find it difficult to fully participate in a review of medicines and other treatments (i.e. those with learning disabilities, cognitive impairment or language barriers.