Epsom Health and Care @Home
The Epsom Health and Care @home service is for people aged over 65 who are living in Epsom and the surrounding areas (including Leatherhead). It particularly supports those who have two or more long term conditions to live as independently as they can and to prevent them getting acutely unwell by co-ordinating all of the health and social care services they need. As extra support and care is provided within a person’s home, it means that people should only have to stay overnight in hospital when they are very unwell.
The service is provided by one team of people from across health and social care services, including community doctors, nurses, physiotherapists, occupational therapists, community matrons and re-ablement assistants from social care. Their role is to support people to live as independently as they can - so they stay well enough not to have to spend time in hospital. The team works from several locations in the Epsom area, including at the New Epsom and Ewell Community Hospital (NEECH), on the Epsom Hospital site, and at Epsom Town Hall.
The team works closely with mental health, voluntary and community organisations, carer and patient representatives, and district and borough councils so are able to access many other community services if required.
The service, which launched in October 2016, is provided through a partnership between Surrey County Council (who provide social care), ourselves - Surrey Downs Health and Care (who provide NHS community healthcare in people's homes), Epsom and St Helier (who provide hospital-based, NHS services) and all of the 19 local GP practices.
The @home team will arrange additional short-term support at home for people who run the risk of becoming acutely unwell or who need extra support after being discharged from hospital. If someone’s care needs to be co-ordinated for longer, they will be supported by the specialist @home community matrons and dedicated care co-ordinators (who arrange all of the care someone needs at home).
The @home team will liaise with the individual, their family and carer(s), and communicate with each other to organise the care and services the person needs. This may include, for example, organising assessments or diagnostic tests, equipment to be delivered and set up at home, arranging outpatient appointments or transport, or arranging visits from community matrons and therapists.
Who will I see?
Staff from the @Home team, who could be a: community doctor, nurse, physiotherapist, occupational therapist, community matron or social care assistant.
Accessing this service
People needing this service will be referred by their GP, health or social care professional.
Referrers can call the @Home Clinician of the Day (COD) on 07812 119 045, where they will be put through directly to a clinician within the team.