Extra Support Service (ESS)

The ESS has been designed to support patients who are frequently attending the hospital A&E Department and those that are frequently calling the London Ambulance Service (999). ESS will try to help patients get the help they need from somewhere else. This innovative service will provide patients with guidance to remain healthy and out of hospital.

The Extra Support Service team consists of a GP, a nurse and a health coach. The nurse and health coach will be available to help between 9am to 5pm Monday to Friday. The team works on behalf of the registered GP practice to ensure your needs are met outside of the hospital to the best of our collective ability.

But please note you still are under the care of your GP and other specialist/community teams. The ESS will work with each patient for a maximum period of 3 to 4 months to hopefully empower the patient with the ability to self-manage their problems better.

The team work together with other community providers to try and help you with your concerns. We can signpost to other agencies and offer advice about self-management where appropriate.

Referring to ESS

At the moment, it is not possible to be referred into the service, either by GP or self referral, as we only accept referrals based on information from Lewisham Hospital A&E department confirming that the patient is a frequent attender.

The service also has some exclusion criteria, so each patient must be assessed on an individual basis before being accepted into the ESS

Positive comments stated by patients include:

“Thank you, the housing got back to me and I have now been moved to a hostel now which is a lot better because I have support here. Thank you”

“The health coach is wonderful. I owe a lot to her. Please thank her for me”

A Patient’s Story – Extra Support Service

Miss B patient is a 23 year old single mother of a 6 month old baby. She has problems with acid reflux causing vomiting, which means she ends up in A&E quite a lot. She feels this is brought on by stress and anxiety. Due to problems with local housing, she had been reluctantly moved from Lewisham to temporary accommodation in East London. She feels this is the big cause of her stress as she has no family support in that part of London and says her current accommodation is unsuitable for a mother and young baby.

The Extra Support Service (ESS) nurse contacted Miss B and learned the underlying reasons for her frequent attendances to A&E. The nurse provided her with an emergency contact number for the ESS nurses so that in a crisis she could contact them, rather than attending A&E inappropriately.

Her case was subsequently discussed at the ESS Multi-Disciplinary Team with other professionals, including the Fulfi lling Lives Team who, after the ESS nurse explained the patient’s situation, were able to liaise with the housing team on behalf of the patient to try and get her and her young baby moved to more suitable local accommodation.
Miss B moved back into Lewisham into a hostel following the actions made by the MDT and her situation has improved markedly.

The ESS nurse’s intervention has ensured that Miss B has:
• Addressed the underlying issues leading to improved healthcare and better health outcomes
for her and her baby;
• Reduced the stress she was under making her and her baby happier and more independent;
• Been able to re-establish contact with her circle of support meaning she is less socially isolated.

Resource impact
Miss B felt greatly helped by the ESS service as the move to local accommodation improved her mental state, and, by enabling her to reconnect with her support network, the life of her young baby. An intervention such as this has helped prevent this patient developing post-natal depression which is common in single mothers, especially those lacking support.

Miss B says about the ESS service:
“Thank you, the housing got back to me and I have now been moved to a hostel in Lewisham which is a lot better because I have support here. Thank you”
Miss B’s A&E attendances and interaction with primary care are significantly reduced.