South West London CCG Annual Report and Accounts 2020/21

discharge from hospital or the management of patient risk that can be handled in the community and primary care. As a result, patients can be kept longer in hospital longer than is clinically required and are admitted into hospital because teams are unaware or have difficulty in accessing community alternatives. During the peaks of the Covid-19 pandemic, primary care and acute hospital clinicians have come together to establish a GP in- reach pilot service at Kingston Hospital. Working within the hospital setting, GPs have offered a primary care perspective, advising on outreach hospital pathways and primary care services that are realistic alternatives to inpatient care or could support earlier discharge. Also, through the GP in-reach service acute hospital and primary care colleagues have worked together on the implementation of the Pulse Oximetry@Home service, enabling patients to be discharged with good quality access to oxygen. The GP in-reach service will be piloted for a further six months. During this time, the service will be evaluated to determine the difference the service makes to individual patient experience, together with the impact of collaborative working across primary and community services, including the reduction in length of stay for patients with long-term health conditions. In addition, some primary care staff were redeployed into local hospitals to support staff during the surges of the pandemic. Expanded primary care services Additional capacity was established at short notice during the peak of Covid-19 surges to help direct patients away from the emergency department over weekends and through to 8.30pm during the week. Post Covid-19 plans for Kingston and Richmond For some people, Covid-19 can cause symptoms that last weeks or months after the infection has gone. This is known as post-Covid. The London Clinical Advisory Group has published guidance to support the management of post-Covid which is to be implemented at an Integrated Care System level. Across South West London we are implementing a networked approach – centralised where necessary and local where possible. This aims to achieve all the benefits of a single South West London wide service, with local delivery where appropriate for patients also accessing local primary care, social prescribing, IAPT and social care support. At a Kingston and Richmond level, acute hospital, community services and GPs are working to identify how we are going to deliver the most effective and accessible post-Covid service for local people. We have begun mapping the services which are in place across all providers (including voluntary sector services) and identifying if and where there are gaps so that we can develop business cases and apply for funding Annual Report and Accounts 2020/21 | 53