202 Development of a be-SPOKE ICPOP clinics in a rural catchment area

Abstract

Abstract Background The hub and spoke model within the healthcare setting is designed around the principle of a main healthcare setting (hub) which offers a full complement of services and investigations and supporting secondary (spoke) clinics, which offer a narrower range of services but may be much more practical and preferable environment for assessment for older adults. This strategic model can meet patient needs fully, allow for appropriate concentration of resources and offers great potential for delivery of high quality patient care. Methods Our aim is to describe the development of several SPOKE clinic in a rural catchment area as part of the Integrated care for Older Persons (ICPOP) service. Results Our catchment covers a population of 38,000, many of whom are living rurally with few accessible public transport options to attend the nearest city for medical assessments. We identified key locations to develop a spoke clinics to deliver comprehensive geriatric assessments on those with new falls, frailty and decline in cognition. We gathered key stakeholders and identified clinical space, listed equipment and upgrades that would be required and process mapped the patient journey compared to attending a city based hub clinic. Our first spoke clinic began January 2023, with two further locations added in April 2023 with positive feedback from patients and caregivers to date. Practical aspects have been praised by patients including parking, distance to clinic room and accessible facilities. Conclusion This model is in its early phase but has been satisfactory to date. An additional benefit has been improved interaction with local services and primary care teams co-located at spoke clinic sites. This model would be suitable to implement in any community catchment area with a large urban and rural population mix.