North Integrated Care Team
Proactive Care in the Community
NICT provide enhanced access to community based support (including specialist provision) for vulnerable people with complex needs, which is designed to keep people well and independent at home. NICT has a focus on care planning and pathways for people who are at high risk of admission to secondary care and those approaching the last year of their lives to enable person-centred joint working across health and social care, involving people and their families in the development of new pathways.
Reactive Care in the Community
NICT enhance the delivery of services that can provide short term support to people to improve their transition home following an admission to hospital, in addition to preventing the need for an admission in the first place and to reduce or delay long term care needs. By integrating the services that currently provide this type of support, improving their capacity to support a greater number of individuals outside of hospital and simplifying access to services.
Same Day Demand in Primary Care
NICT manage urgent (same day) demand for statutory services including primary and social care through improved information and advice, the promotion of self-care and self-management, and asset and strength based approaches. The team aims to improve the sustainability of primary and social care, releasing GP and other professional time to provide proactive care for vulnerable people with complex needs and building urgent care networks between surgeries and with the Emergency Department.
The NICT service provides a person-centred approach to patient care. All patients will have a named care coordinator from within the service for the duration of a short term intervention. Each patient will be closely involved in setting their own goals and be given a copy of their support plan. The Service supports timely discharge from acute or community beds into Step Down beds or people’s homes and provides Rapid Response to help prevent avoidable admissions.