PROVIDING ‘tailored’ help at home for people who’ve been in hospital could help them get home sooner and save the NHS millions of pounds.
That’s the finding of a trial NHS programme in Somerset, which has helped patients avoid 7,500 nights in hospital and freed up at least £2 million for other services.
The pioneering “Homefirst” scheme offers patients who are healthy enough (and their families) tailored help to finish therapy at home, with personalised care reducing stays in hospital by up to 10 days. Described by health leaders as “a common sense approach”, Homefirst is delivered by specialist teams of staff who have been given additional training in a range of care techniques, so they can do more with patients once they’re home, to help them regain independence more quickly.
The NHS Long Term Plan, unveiled this month, sets out how care will increasingly be integrated within communities, with different health services, councils and other agencies working closely together to provide faster, more convenient and more joined-up care within each district.
In Somerset, instead of waiting to complete in-hospital assessments – such as ‘walking the ward’ in a busy unfamiliar place – people can be safely discharged home at the right time for them and then receive support for important tasks, based on their home and enabling a quicker and happier recovery. The Homefirst team plays a key role in determining when a patient can be safely discharged home with the right help.
Team members visit patients on the wards at Somerset’s two acute hospital to discuss their ongoing needs, and involve families in the decision-making process. They also liaise with medical and nursing staff to ensure patients are comfortable and happy that they can be discharged safely at a time that’s right for them.
Tim Baverstock, who led the scheme for Somerset County Council, said: “We’ve found that all it can take to avoid a long hospital stay is a frank conversation with the patient and family to learn more about how they can manage at home and their wishes.
“If someone starts to recover they often want to go home, but previously paperwork and assessments could have meant waiting weeks. While the patient waits their mobility and independence reduces and causes frustration – a person over 80 who spends 10 days in hospital loses 10% of muscle mass, equivalent to 10 years of ageing. We wanted to bring an end to that.”
Similar ‘Integrated Care Systems’ – involving various partners working closely together to make patient-focussed improvements – are now operating or being trialled across the country. Ultimately the best elements of each scheme could be combined in a national system helping hospital patients across the country to be safely discharged home sooner, with ongoing care provided in the community. This will go a long way to resolving the so-called “bed blocking” problems experienced by many NHS Trusts.
Dr Karen Kirkham, NHS England’s National Clinical Advisor for Primary Care, said: “As we deliver on the Long Term Plan for the NHS, it is common sense schemes like this which are being rolled out across the country to get the best care for patients and make the best use of every penny. By finding out more about a patient’s circumstances at home we can tailor the care they get.”
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