The Ashford Hub team provides proactive care for medically stable patients. They focus on prevention, encouraging self-care, identifying risk factors and managing these early. The service is particularly suitable for people who may benefit from support from both health and care services. The Hub also provides a reactive service, which aims to rule out conditions requiring immediate hospital treatment and to support people to stay at home if this is safe and appropriate.
The Ashford Hub service aims to identify people with frailty or at risk of frailty at an early stage. Patients will receive a multi-disciplinary proactive assessment to identify their needs and be provided with advice and treatment. They will also be signposted to suitable services and have support put in place to help avoid a health or social care crisis.
The Ashford Hub is not an alternative to GP or local community services, but works in partnership with these other services to provide a coordinating point for people with frailty.
People on the Hub caseload can access the service, and health and care professionals can refer them for a review, without the need for re-referral. If, following a review by the Hub GP / Hub matron, we feel that a person no longer needs the assistance of the Hub services then they will be discharged, and their family doctor (GP) informed.
People on the Hub caseload can access the service, and health and care professionals can refer them for a review, without the need for re-referral. Each person is allocated to a Hub coordinator, who will ring people on the caseload on a regular basis depending on need.
The patient's care record is shared with health, mental health and social care professionals involved in their care (following patient consent) and the team is notified when people on the caseload attend the Ashford & St Peter's Hospital A&E department or call the ambulance service. This helps the Hub team identify when people may be going into crisis so they can offer support if necessary.
Specialist clinics are held in The Ashford Hub for people on the Hub caseload.
People are encouraged to come to The Ashford Hub for appointments if possible. All sites are fully accessible with good transport links including parking. Please ask a member of our team if you require further information about how to get to the Hub. Outreach visits are provided for people who are unable to come to the Hub.
