Teams working with high intensity users of health services in BSW report positive results

Visits to Accident and Emergency departments, unplanned admissions to hospitals and calls to 111 by people who are disproportionally high users of health services have fallen significantly thanks to a new pilot service currently in place across B&NES, Swindon and Wiltshire.

The BSW High Intensity User Service offers a robust way of supporting people who make high intensity use of health services, in particular A&E, hospitals, 111, mental health and other health services.

The BSW service contacts the individual to uncover the real reason for accessing emergency services. This often reveals a range of complaints including social issues, mental health, loneliness, addiction, complex medical presentations, or a combination of any of these factors.

The service listens to the needs of the patient with a friendly approach, supporting them into finding solutions to their issues, aiming to reconnect them back to a better life, to their families, to their communities and often helping them to access the appropriate services in a less chaotic style.

The service in BSW involves a number of agencies, including the Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board, Medvivo and Wiltshire Centre for Independent Living who work together to help the individuals concerned.

The service is also helping to save money, time and resources. A report (by Dr Foster 2017/18) showed that nationally around 5000 people attend A&E units more than 20 times each year. In 2016 patients that attended more than 20 times in 12 months accounted for 0.05 per cent of A&E visitors but with a cost to the NHS of £53 million, around 3 per cent of spend.

In BSW the High Intensity User Service has been responsible for a 59 per cent reduction in A&E attendance, a 34 per cent in people calling 111 and a 53 per cent drop in non-elective admissions among the 271 high intensity service users it has been working with. These reductions have resulted in a £79,400 saving for A&E and £245,600 in terms of hospital admissions.

Since the pandemic, the organisations that attend regular meetings and are working together to support high intensity users have increased and now includes 111, social care and local police services. 

Mary Reed, Chief Executive Officer at Wiltshire Centre for Independent Living said the success of the scheme lay in both reduction is use of services and the benefits for the individuals the teams worked with.

“The reduction in visits to A&E, hospitals and calls to 111 are a great achievement and illustrate how valuable the service is, but it’s also important to recognise that there are wider benefits for the people we are working with and the communities they live in in terms of supporting people to live their best lives, so they are happier, more resilient and productive individuals.”

We know that if some of our high intensity users experience a future crisis once we have started working with them, instead of falling back into old ways and calling 999 or attending A&E, they will call us and we work with them and have a chat.”