Our High Intensity User service was commissioned by Lewisham CCG to support patients who are frequently attending A&E inappropriately. Patients are referred to the service based on their symptoms and the frequency of their visits.

They can be offered access to a HIU nurse helpline between 9am and 5pm Monday to Friday and/or pastoral support by our Health Coach through Community Connections. Dr Enpan Kuncharalingam, Clinical Lead for the HIU service said: “The patients that are seen in this service present with complex conditions and often have chaotic lives. They need help but are often going to the wrong place to get the support they need. Our team are experienced and equipped to help, support and advise these patients. It is an important service providing crucial support to a vulnerable cohort of patients, and I am so pleased that we are able to offer it to these patients”.

The team are fully in place now and referrals are coming through. If you would like more information about the service please email Dr Enpan Kuncharalingam (enpan.kuncharalingam@onehealthlewisham.co.uk).

Our HIU service helps patients like this:-

Sean is a 50 year old man with frequent attendances to Lewisham Hospital A&E department. He was invited to work with the Extra Support Service (ESS) organised by One Health Lewisham. The main problems identified by ESS were anxiety, loneliness, financial problems, and a chronic lung condition.

With the aid of ESS, Sean was invited to meet with the ESS Health Coach, who was able to encourage him to join an arts and crafts group and a mental health support group in the community. This helped to combat his isolation and Sean learnt new skills that helped to improve his resilience. He was also given practical support about how to appeal the decision for having his benefits reduced.

The ESS nurse was able to explain how to take his medications appropriately and when to seek advice from a health professional about his symptoms. These interventions helped to reduce his inappropriate attendances to A&E, which benefited both the patient, the community of Lewisham and the NHS.