These services are not run by the practice but are available to registered patients of Elm Hayes Surgery.
We have a team of Care Coordinators that are based across our Primary Care Network and at Elm Hayes Surgery.
Care coordinators proactively identify those people who may be vulnerable or have specific needs and provide coordination and navigation of care and support across health and care services.
They manage a small caseload of patients ensuring their changing needs are met as well as supporting individuals in a less formal way. This could be by answering queries, making and managing appointments, providing information and connecting them with other services such as social care and social prescribing.
They will use PAM (patient activation measures) to support people to understand their level of knowledge, skills and confidence when engaging with their health and wellbeing and help people access courses, peer support and other interventions to improve their health. This will be documented using a personalised care support plan (PCSP)
They will need to work closely with clinicians, reception teams, social care, community services and social prescribing link workers (SPLW).
There is some overlap with the role of the SPLW but usually care coordinators are more involved in the practicalities of identifying those with need and joining up care whilst SPLW give people the time to focus on what matters to that individual and then connects people with community groups and agencies to build a wider team around the patient.
Midwifery Services are offered by the team of Midwives at Paulton Hospital. Please contact 01761 412315.
How to contact our District Nurse and Community Matron.
Routine messages can be left with our reception team who will pass these onto the Community Teams at the earliest opportunity. The Community Nurses call into the surgery at least twice a day to pick up these messages and urgent messages can be relayed to them if necessary.
Services we offer
District Nurses provide evidence based, skilled nursing care to housebound and terminally ill patients, including:
- Complex assessment of health needs
- Palliative care
- Acute and chronic disease management
- Administration of treatment using specialised nursing equipment
- Promotion and maintenance of health independence
- Education and support to patients, carers and colleagues
We are unable to make precise appointment times, as our daily work and travelling time is quite variable. We do not provide an emergency service.
Other People who may also be able to help you at home:
- Social Services provide basic social care. If you need help with personal hygiene, bathing, meals, housework, shopping, day care, respite, getting up, going to bed or toileting, then they may be able to help you – Tel: 01225 477000.
- Voluntary agencies have expertise to advise and help you complete benefit for:
1. Citizens Advice Bureaux Tel: 01225 463333
2. Swan Welfare Rights Advice Tel: 01761 437176
- Community Pharmacist – If you require delivery of a prescription or need a dosette box filling then please contact your Chemist.
We are happy to offer advice, and if we are unable to provide a particular service, we can usually point you in the right direction.
The health visiting team are not based at Elm Hayes Surgery. For more information about health visitors please refer to the website