Information
IMPACT: IMProved Anticipatory Care and Treatment
An Edinburgh based Community Long term condition team, to improve patient care and reduce admissions.
The team
- comprises of Advanced Nurse Practitioners, District Nurses and community staff nurses.
- Works across the 4 localities of the City of Edinburgh
- Operates 7 days 08.00-16.30
We aim to respond within one week of referral – if the need is urgent we may respond more quickly, but we are not an emergency service
Contact details:
IMPACT team single point of contact: 07917215009
Impact.clinical@nhslothian.scot.nhs.uk
SCI Gateway: Astley Ainslie Hospital>Anticipatory Care>L IMPACT Referral
Referral Guidelines
The IMPACT Service is aimed at people with Long term conditions and their carers. Our focus is to work with patients and carers on symptom recognition to prevent avoidable hospital admissions.
The main conditions include-:
- COPD
- Bronchiectasis
- Pulmonary Fibrosis
- end stage Heart Failure
- Frail elderly.
In the longer term IMPACT supports patients and carers to understand their long term conditions in order to make achievable lifestyle changes and improve medication concordance.
Any health professional may refer to IMPACT. All referrals will be reviewed prior to acceptance.
Please ensure the patient has consented to the referral.
Information to include with referral:
From acute services: hospital discharge letter with medication or IMPACT referral form
From community services: GP home visiting sheet via SCI Gateway
From services unable to access the above: Complete IMPACT referral form
Who to refer:
Patients must
- Be aged over 16 years
- Be registered with an Edinburgh GP
- Have one or more long term condition
- Be willing to engage with the service, or have someone able to engage on their behalf
Patients must also meet at least 2 of the following criteria
- 2 or more hospital admissions related to a long term condition in the past 12 months
- 2 or more A&E attendances related to a long term condition in the past 12 months
- Uncontrolled symptoms/recent exacerbations of condition
- Polypharmacy (>6medications)with medication management issues and a long term condition
Who not to refer:
Patients who are
Alcohol/substance misuse compromising ability to engage with case management
Unwilling/unable to engage with IMPACT
Requiring end of life care
Patients whose only LTC is a mental health condition
SPICT. Future Care Planning REDMAP pocket guide https://www.spict.org.uk/wp-content/uploads/2023/10/REDMAP-cards-for-staff-September-2023.pdf
Ihub. Future Care Planning Toolkit https://ihub.scot/project-toolkits/future-care-planning-toolkit/future-care-planning-toolkit/
NHS Inform. Future Care Planning – https://www.nhsinform.scot/care-support-and-rights/decisions-about-care/future-care-planning/
TURAS Learn. Realistic Medicine – Having Realistic Conversations https://learn.nes.nhs.scot/60442
