What’s this project all about?
Joined-up care is improving life for people with complex respiratory conditions.
People living with severe frailty and respiratory disease in East Leeds are receiving more coordinated support through an Advanced Respiratory focused programme, helping them stay well at home and access the right care more quickly.
Delivered through the Cross Gates and Seacroft Local Care Partnerships, the work brings together a care coordinator, community matron and a network of health, care and voluntary sector professionals around each individual. By working together, the team can respond more proactively to people's changing needs and provide support that goes beyond medical treatment.
This work is one example of Neighbourhood Health in action across West Yorkshire, where organisations are working more closely together to provide joined-up, personalised care in local communities.
Practical support that makes a difference
Since launching, the initiative has provided:
- additional support from the community respiratory team
- support for carers
- practical, non-medical help to improve wellbeing, including arranging domestic cleaning services, equipment and financial support
- access to advice through a support line led by Telecare at Leeds City Council in partnership with the Yorkshire Ambulance Service
Listening to the whole person
The work is helping people and their carers feel more supported by providing regular contact with familiar professionals who take time to understand their wider needs.
Rather than responding only when someone becomes unwell, the team works proactively to coordinate support, improve continuity of care and connect people with the services they need before problems escalate.
People say this way of working is making a difference
Debra, whose husband John is benefitting from the project, said:
“They have been coming quite regularly and when they come they engage with John and actually listen to what John says.
“So rather than a doctor who would come in and diagnose they actually spend time listening to John’s version of events. It’s more holistic. They may come to just ask him about his chest but then they ask about other aspects so there is an overall concern and interest in his whole condition rather than just one specific aspect of it.
“I really like that they can get us in touch with other departments quite quickly. For instance, if John needs other breathing assistance they are the conduit to get us in touch with the right people there.”
Beryl, 90, who is benefitting from advanced respiratory proactive care, said:
“I’ve got a nurse come to see me regularly and she is great. She got me on oxygen that I can’t thank her enough for because I’ve been great since I’ve had it at home.
“I like it (the project) because it’s the same people who come to see me, and they have done so much for me, and I feel better when I know that somebody is coming to look after me and see if I need anything.”
Building on what works
The work is showing how proactive, coordinated care can improve the experience of people living with complex respiratory conditions and severe frailty. As the work develops, partners will continue to strengthen the approach, build on what they have learned and explore how similar ways of working could benefit people in other neighbourhoods across West Yorkshire.
You can also read the 'advanced respiratory initiative helps people in East Leeds stay well at home' case study as a PDF.