When people think about the services IC24 delivers, it’s often our larger contracts that come to mind. But some of our smallest services are making an extraordinary difference to patients every single day.

Our GP service at Victoria Care Homes is a perfect example.

Across May and June, Dr Jess Heaver completed 56 consultations, with zero hospital admissions from the 30 NHS-commissioned intermediate care beds. For a service supporting patients who have only recently left hospital, this is a significant achievement and a clear example of the value of proactive, joined-up care.

Victoria Care Homes consists of three homes, registered with the Care Quality Commission to provide nursing care for 68 residents. Of these, 30 intermediate care and rehabilitation beds are commissioned by the Sussex ICB, with IC24 providing dedicated GP cover to support patients recovering after a hospital stay.

Every Monday and Thursday, our portfolio GP, Dr Heaver, carries out ward rounds as part of a highly skilled multidisciplinary team alongside nurses, physiotherapists, occupational therapists and care staff. Patients admitted to the service are often recovering from acute illness, surgery or injury and need intensive rehabilitation before they are well enough to return home safely.

As Dr Heaver explains:

"Patients will come into our care after a hospital stay and sometimes they may have had repeated stays. We take adult patients of any age, but patients tend to be elderly and have multiple health conditions. Rehabilitation goals can range from climbing stairs safely to being able to transfer independently. Often patients have lost their confidence, and it is brilliant to see this return."

Continuity of care is central to the service. During her ward rounds, Dr Heaver provides proactive medical reviews, works closely with the wider MDT and coordinates care with other specialist services when needed.

That continuity does not stop when she leaves site.

On the days she is not at Victoria, the care homes have direct access to IC24’s Roving GP Service, enabling a GP to attend within one hour if a patient becomes acutely unwell. This rapid response ensures residents continue to receive timely medical assessment, helping to avoid unnecessary delays in treatment and supporting clinical decisions in the most appropriate setting.

Reducing avoidable hospital admissions and preventing readmissions are recognised NHS priorities for intermediate care services, which exist specifically to help people recover following illness, maximise independence and avoid unnecessary hospital stays. To achieve no admissions over a two-month period reflects the strength of the partnership between IC24 and Victoria Care Homes, and the commitment of the multidisciplinary team to delivering proactive, patient-centred care.

As Dr Heaver says:

"As the main GP covering these sites, I can provide continuity of care and reach out to services if needed, such as Frailty Same Day Emergency Care. As a team we work towards safe discharges and patient care that tries to stop the revolving door of preventable readmissions. I believe we make a real difference to patients and I am very proud of the team that we have here."

In a healthcare system where success is often measured in large numbers, our Victoria Care Homes GP Service is a reminder that impact is not always about scale.

Every avoided admission represents a patient who was able to continue their recovery in familiar surroundings, supported by professionals who know them, without the disruption and risks associated with another hospital stay.

It is one of IC24’s smaller contracts, but its impact is anything but small. Through close partnership working, rapid access to medical care and a shared commitment to rehabilitation, the team is helping patients regain their independence, recover closer to home and achieve the outcomes that matter most.