A Model That Works: Cross-Organisational Delegation in Care Homes

What happens when a Registered Nursing Associate is embedded within a residential care home and works closely with District Nursing teams through a cross-organisational delegation model?

At Ebury Court Care Home, we found out. The results are clear. Care home staff have gained confidence and access to additional clinical expertise. Residents receive more timely clinical support from someone they know and trust. District Nurses are able to focus their time where it is needed most. Most importantly, the model has become fully embedded into everyday practice.

What began as a pilot is now business as usual at Ebury Court.

As the Registered Manager explains:

“What began as a pilot has become simply the way we work and we would not have it any other way. Our fabulous RNA, working closely with our wonderful colleagues from the District Nursing service, enables our residents to lead better and healthier lives as they receive timely, expert clinical care from someone they know and trust.

This is not an experiment. It is a model that works, that is already delivering every day for our residents, and every care home in the country should have access to this. In our view, the case for rolling this out nationally is overwhelming.”

NELFT’s Integrated Community Service Manager agrees:

“When initially approached for this pilot, cross-organisational delegation of this kind was new territory for our team and created both anxiety and excitement in line with service transformation and an enhanced patient experience. This has now become embedded in practice and is simply part of how together, these clinicians deliver safe and effective patient care.

This is what good community nursing looks like when the right partnerships are in place, and we are in no doubt that this model should be replicated more widely to enhance the patient pathway“.

Our evaluation explored how the model was implemented, the impact it had on residents, staff and services, and the lessons learned along the way.

The findings suggest that residential care homes can successfully host enhanced clinical roles and work in partnership with NHS teams to deliver more integrated care.

We’re already working on scaling this model in partnership with Rayne Foundation. Building on the learning from the pilot at Ebury Court, we have adapted the model to expand to domiciliary care settings where we are supporting the development of Nursing Associate and Assistant Practitioner roles.