Proactive Care Team (formerly Transformation Team)

What does the team do?

The Transformation Team was set up in 2014, with the aim of coordinating, expanding and improving the provision of care to the more frail and vulnerable patients in our communities. From April 2026 the team has evolved and is now called the Proactive Care Team. The team is led by proactive nurses who have previously worked as community nurses, and the team includes  therapists, social practitioner(s) and healthcare assistant(s). The Proactive Care Team conduct a holistic review of patients and their carers, taking into account medical, social and care needs. They will also talk about your future wishes and if you are having any difficulties with everyday tasks. Working closely with local PCN pharmacists, volunteers and health agencies the Proactive Care Team help put in place packages to help care for our vulnerable patients and assist patients to maintain independence as much as possible. Patients are identified from local health platforms, and referrals can be made by General Practice, Community Teams and local hospitals. The Team work closely with Community Elderly Care Consultants and the Frailty Team for support with clinical expertise.

Who is in the team?

Charlotte (Team Lead)

An experienced Community Nurse. Charlotte is responsible for team management, patient allocation, clinical supervision, triage, and holistic assessments. Charlotte also supports the Eastleigh complex wound clinic.

Tracy (Nurse)

Another experienced Community Nurse. Tracy is responsible for triage, patient allocation, team support and holistic assessments. Tracy also supports the Eastleigh complex wound clinic.

Lesley (Therapist)

As an experienced Community therapist Lesley is responsible for mobility and falls assessments and advises the Team and patients on equipment. In addition Lesley can conduct holistic assessments and annual housebound COPD reviews.

Michelle (Social Practitioner)

Michelle's background was working with Adult services and she is responsible for supporting the Team in social care issues and conducts holistic assessments as well as specific social care needs reviews.

Mandy (Health Care Assistant)

Mandy provides therapy support, frailty assessments and annual housebound Diabetic reviews as well as supporting the Eastleigh complex wound clinic.