Case studies of frequent callers

The following are some examples of cases undertaken by the unit:

• An elderly patient who was socially isolated had placed 99 emergency calls over a five-month period at a cost of £16,335. A case conference was arranged and the evidence of calls made to was used to facilitate a placement at a specialist residential care unit. No further calls have been subsequently received. 
  
• A patient placed 51 emergency calls over a three-month period at a cost of £8,415, in relation to experiencing breathing difficulties. Our Patient Advice and Liaison Service (PALS) contacted the patient’s GP to discuss the possibility of prescribing home oxygen. The GP was apparently already considering this option, although our information about number of emergency calls  provided further evidence of the patient’s needs. Home oxygen was duly prescribed and no calls have been received since that time.
  
• A patient with chronic obstructive pulmonary disease, asthma and bronchitis, who also displayed an acute anxiety condition, placed 238 emergency calls within a period of two months, at a cost of £39,270. Whilst the patient invariably reported severe breathing difficulties, these did not prove to be clinically significant. PALS was able to liaise with the GP, the local hospital ‘fast response’ team and the community social worker. Using the evidence of the frequency of calls to our service, it was arranged for the patient to be admitted to a rehabilitation ward, where he received support to promote independent living. This evidence was also used to refer the patient to a social services panel and funding was subsequently agreed for a placement at an enhanced sheltered housing scheme with access to 24-hour staff support.
  
• Having established a relationship with an acute trust, the patient experiences department were invited to attend a case conference in respect of a frequent caller who had multiple admissions at A&E. The duty station officer who attended was able to identify that the calls were being made by the patient’s carers and always occurred around late afternoon. As the patient is a diabetic, it emerged that dietary needs were the cause of the problem. A care plan was designed to include support from the diabetic nurse and additional carer input from social services to address this.