Helping to address delayed discharges

A new specialist service in South London is bringing together housing, clinicians and discharge teams to work with patients whose housing problems are delaying their discharge from hospital | NHS Confederation

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This briefing reports on a a new specialist service based in Croydon, South London. The service  supports patients to move on from hospital to either supported living, the private rented sector, council properties or hostel accommodation. They are helped to access funding, legal advice, benefits and other services.

Insecure housing is often cited as reason for patients being admitted to hospital. The Crisp report (2016) found that 16 per cent of patients on acute wards were delayed discharges, and that 49 per cent of these patients could not be discharged due to a lack of suitable housing. In response to this, South London and Maudsley NHS Foundation Trust commissioned a new specialist service to be based within Bethlem Royal Hospital to work alongside clinicians and the current discharge team.

Since launching in February 2017, more than 200 patients in Croydon have been supported with housing, which has allowed them to leave hospital quicker.

Full briefing: Helping to address delayed discharges in South London: the HAWK/SLaM service

 

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Allied Health Professions supporting patient flow

This quick guide demonstrates how NHS emergency care, in particular patient flow through the health and care system, benefits from allied health professionals | NHS Improvement

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Bringing the AHP workforce into patient flow planning can improve quality, effectiveness and productivity.

Each section gives a brief overview of the contribution that AHPs have made to deliver safe, effective patient care and flow, followed by case studies which demonstrate how AHPs:

  • work in the community keeping people safe and well at home
  • ‘front door’ assess, diagnose and treat patients in emergency departments, ambulatory care and assessment units
  • support avoidance of hospital admission
  • enable early rehabilitation and reducing overnight admissions
  • drive ‘Home First’ (discharge to assess) to avoid in-hospital deconditioning of frail, older people.

Full detail: Quick guide: allied health professions supporting patient flow

Reducing delayed transfers of care over winter

NHS Improvement has written to the chief executives of all trusts providing community services setting out actions they must implement to reduce delayed transfers of care over winter. | NHS Improvement | HSJ

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NHS Improvement  chief executive Jim Mackey has said trusts must help improve delayed discharges over winter and listed six actions they need to carry out in the next six months:

  1. Facilitate the sharing of patient data with acute and social care partners and from 7 November ensure daily situation reports are completed “to enable better understanding of community services at a national level”.
  2. Jointly assess discharge pathways with local partners including “being an active participant in the local acute provider’s discharge and hosting operational discussions daily where necessary to discharge patients in community settings”.
  3. Develop “discharges hubs” over the next six months and beyond, designed to be a single point of access for patients moving between acute and community services.
  4. Ensure a “robust patient choice policy” is implemented.
  5. Clarify to partner organisations what services the trust offers to patients.
  6. Ensure collection of patient flow data and data on plans to improve patient flow.

Full detail is given by NHS Improvement who have produced the following  report to help improve flow into and out of community health services:

Flow in providers of community health services: good practice guidance

Related HSJ article: Trust chiefs given new instructions to tackle winter DTOCs

Acting without delay – How the independent sector is working with the NHS to reduce delayed discharge

NHS Confederation, June 2017

This report from the NHS Partners Network highlights examples where the independent sector is working with the NHS to avoid delayed discharges of care.  Reducing delayed discharge – where often frail and elderly patients are unable to leave hospital due to necessary care, support or accommodation in the community being unavailable – is arguably one of the biggest priorities for the NHS.

Delayed discharges and transfers of care (DTOCs) have a significant impact on the ability of NHS acute trusts to provide routine treatment such as elective surgery. It is vital, both for the patient and the trust, to be able to discharge patients speedily to avoid adverse effects to patient flow.