Aims and objectives of service
There are eight multi-disciplinary Neighbourhood Teams working in partnership with primary and social care professionals. Each one is allocated to one of the eight Nottingham Care Delivery Groups (CDGs) to offer local people access to integrated health and social care.
The Neighbourhood Team is responsible for providing nursing and rehabilitation support to adults who require care in their own homes due to long term chronic disease or as a result of an acute episode of ill health.
The team provides ongoing case management or rehabilitation to people affected by long term conditions or complex needs from multiple conditions.
The Neighbourhood team brings together all health and social care providers so that there is a co-ordinated approach to end of life care that benefits the patient and supports the patient’s wishes and preferences.
On receipt of a referral the team assesses the person's nursing and therapy needs including reviewing their medication and social situation, their functional ability including mobility and Activities of Daily Living (ADLs).
Following this review the team will generate or update a personalised care plan incorporating both health and social care interventions appropriate to the individual’s needs. This may include: acute nursing; administration of medication; breast drains; case management; continence/catheter management; continuing care; end of life/palliative care; equipment; falls risks; rehabilitation; nutrition; skin and wound care; vaccinations and Assistive Technology (AT).
Hours of operation
Community nursing services are available from 8.30am to 5pm, 365 days a year. All other services are available between 8.30am and 5pm, Monday to Friday, exclusive of Bank Holidays.
The service operates an open referral system accessible via Nottingham Health and Care Point for self referrals; via the CDG Care Co-ordinator from health and social care professionals when there is a need to define the appropriate clinical response and directly to the service from health and social care professionals for people who are known to the multi-disciplinary team.
The service is available to anyone aged 18 or over registered with a NHS Nottingham City Clinical Commissioning Group GP practice, resident within an appropriate radius of the city boundary who meets the service criteria.