2780 Avoiding acute admissions by working in a multi-disciplinary team alongside paramedics in the West Kent clinical navigation hub

Introduction Home Treatment Service (HTS, a Frailty Hospital at Home model that provides Comprehensive Geriatric Assessment, diagnostics and treatments to avoid hospital admission for people with frailty) within Kent Community Health NHS Foundation Trust has increased links with the Acute and Ambulance Trusts. The MDT interacts with visiting paramedics within a clinical navigation hub (CHUB). Method 61 HTS referrals from the CHUB were compared with 61 direct clinician referrals from December 2023 to February 2024. The NEWs score, length of stay (LOS) and Advance Care Planning (ACP) documents were analysed. Results The average LOS under HTS via the CHUB was 2.61 days and 3.65 days for direct referrals. 27% of NEWS scores from the CHUB were high compared with 14% from direct referrals. 48 out of the 61 (78.6%) patients identified as requiring HTS by the CHUB had no ACP documents (the presence of a DNAR was not counted as this does not give community options). 37 out of 61 (60.6%) had no ACP on direct referral to HTS triage. Conclusion(s) Referrals directed to HTS proactively from the CHUB have a higher percentage of NEWS scores that would require hourly observations and/or escalation to medical assessment. The CHUB explores community options while weighing benefits and risks of transfer to hospital in real time. The LOS between the two referral sources is not hugely different and suggests that we are identifying patients requiring similar management regardless of source of referral. The CHUB gives options to patients who have fewer advance decisions recorded to support the direction of their care at the point of an emergency response. The CHUB allows HTS to access a different group of patients who may not have had routes to HTS enabled previously.