Improving quality of life for people living in care homes – how the Enhanced Health in Care Homes framework is supporting proactive, personalised care

As the Enhanced Health in Care Homes framework is published, Emma Self from NHS England shares with us what it means for people living in care homes and those who support them:

“The Enhanced Health in Care Homes (EHCH) framework is not new – the initial framework was published in 2016 as best practice guidance following pilot projects which aimed to improve the health and wellbeing of people living in care homes.

A key commitment in the NHS Long Term Plan to roll out EHCH to all care homes in England by 2024, meant that version 2 of the framework came with key contractual requirements for both primary care and community service providers, namely:

Every care home:

to be aligned to a named primary care network (PCN)
to have a named clinical lead
to be in receipt of a weekly home round supported by a multidisciplinary team (MDT)

For every care home resident within 7 working days of admission/readmission:

to have a comprehensive assessment of health and care needs
to have personalised care and support plans developed based on the assessment

For me, this all starts with the desire to work together collaboratively to improve health and care for people living in care homes; having a commitment to teamwork and innovation, and fostering an attitude of professional respect and understanding for all those involved in planning and coordinating care for residents.

This is mirrored in the key findings from the Optimal study, shared by My Home Life England in Issue 20 of their bulletin, who highlighted that in order to achieve improved satisfaction with healthcare provision, with better resident access to NHS services and the avoidance of crises, the following should be in place:

Agree shared aims between the care homes and the NHS
Understanding the importance of care homes and the NHS working together
A joined-up approach across the whole system
All NHS and care home staff need to have understanding of and access to expertise in dementia

Whilst not every unplanned admission from a care home to hospital is avoidable, a significant number can potentially be avoided with proactive, personalised care planning.

The contractual elements that underpin EHCH, support and enable the creation of individual advanced clinical management plans (personalised care and support plans) by describing the infrastructure and best practice that should be in place for delivering EHCH.

Central to all of this should be the people who live in care homes and the care home staff that support them.

Visiting healthcare professionals will not know the person as innately as the care home staff. Therefore we should be collaborating as a system across health and social care, utilising the expertise of all Multi-Disciplinary Team members to provide proactive and personalised care for residents which supports them to live and die well in their care home.

I’m delighted that version 3 of the EHCH framework has now been published.

This latest update reflects best practice and new ways of working since the COVID-19 pandemic.

At NHS England we engaged with over 500 key stakeholders across health and social care. Their expertise and insights have informed the development of this version. New sections include the use of digital technology to improve integrated working and information sharing across health and social care teams. It also expands on several priority clinical areas – such as structured medicine reviews, nutrition and hydration, falls prevention, skin and wound care, leg and foot ulcers, mental health, dementia and palliative and end of life care.

If you’re interested in finding out more please visit the website here.

This video here outlines how teams work together to provide quality care for the people we care for.

We also want to hear about how you and your colleagues are providing high quality care for people who live in care homes – please email our team to share your stories: england.communitycare@nhs.net

Emma Self

Service, Policy, Delivery and Implementation Lead for Enhanced Health in Care Homes, Community Health Services, NHS England