Working together, works well


Robert Scarlett was discharged from hospital just in time for Christmas after almost a year of treatment for breathing difficulties.

It should have been a happy occasion, but sadly Robert’s wife passed away from cancer while he was being treated.

Returning to an empty house after 45 years of marriage, Robert felt lonely and frightened. He had been his wife’s primary carer throughout her battle with cancer, but now could not even walk down the stairs.

Robert’s confidence was low and he started to suffer from panic attacks. “I felt terrible, really, and lonely. I had no one to speak to and it was just not the same,” he said.

Luckily, Robert’s medical practice managed to offer him some help. They put him in touch with Sylvarani, a personal independence co-ordinator from Age UK, who helped him get back on his feet. She worked with GPs, pharmacists and social care professionals to talk about Robert’s needs and concerns.

She began to set Robert daily goals while helping him manage his medication.

To help him manage the stairs, she arranged to have a bannister installed. Now Robert can move around his house freely.

Robert Scarlett at home

When Robert came out of hospital, he only had an electric heater to keep warm during the winter months.

When Sylvarani began working with him, she applied for financial support and liaised with his landlord to have central heating installed in the house.

Robert said: “I am so much more confident now and it’s all thanks to the support I received. I’m well enough to start driving again.

“And I’ve not been back in hospital since.”

The One Croydon partnership of GP and NHS services, Croydon council and Age UK Croydon offers 18 co-ordinators like Sylvarani for older people in the borough. It aims to help residents manage their conditions independently to reduce hospital visits.

Dr Dev Malhotra, a GP at Brigstock Road Medical Practice – the first GP surgery to adopt the scheme, said: “We know that people’s care is better when organisations work together to provide health and social care, physical and mental health.

“As a GP, I’m able to help people manage their physical health – but it’s only in the last year that we’ve been able to look holistically at people’s overall wellbeing, through an integrated meeting that brings together local health and social care organisations.

“By taking care of Robert’s immediate health needs, as well as his wellbeing, we’re strengthening our focus on keeping people well – and out of hospital.”

Dr Agnelo Fernandes, Croydon CCG GP chairman, said: “Working together the NHS, Croydon council and Age UK Croydon are sharing their knowledge of communities, and their resources, to make a huge difference to the lives of people like Robert. In this way, we can support people’s health and social needs as part of one team.

Councillor Louisa Woodley, Croydon council’s cabinet member for families, health and social care, said: “The One Croydon alliance makes better use of professionals’ resources so Croydon residents can manage their conditions better and do more of what they love.

“Successes so far have included 62 per cent fewer patients needing care packages for longer than six weeks after leaving hospital, and everyone in the One Croydon alliance will continue to work together so we get better results for our residents.”

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