3 August 2020

In response to the COVID-19 pandemic, local healthcare partners have joined up to improve the hospital discharge process for patients, reducing the time patients wait for discharge support services by an average of two-and-a-half days.

In March, the Government published new discharge guidance for NHS Trusts to follow until the end of the COVID-19 pandemic. The guidance set out the immediate actions that had to be taken to enhance discharge arrangements and the provision of community support to deliver safe and rapid discharge for people who no longer need to be in a hospital bed.

The Shrewsbury and Telford Hospital NHS Trust (SaTH), Shropshire and Telford and Wrekin Clinical Commissioning Groups (CCGs), Shropshire Community Health NHS Trust (Shropcom), and Shropshire and Telford & Wrekin Councils have united to enable a successful multiagency and multi-disciplinary process for the people of Shropshire, Telford & Wrekin and mid Wales.

An Integrated Discharge Hub was launched to provide rapid access to discharge services once a patient is ready to leave hospital. All referrals are now made by telephone, triaged and discharge arrangements organised by the multi-professional team, with the aim of discharge taking place on the same day whenever possible.

For the first time, all partners working as part of the Integrated Discharge Hub are co-located at the Royal Shrewsbury Hospital, and the service is provided seven-days-a-week. This new way of working provides an enhanced discharge process and the support offered will improve patient experience.

To date, the Hub has received 1,367 complex discharge referrals, and the team focuses on a ‘home first’ philosophy. Many patients are able to return home with wrap-around support, within hours of being told by the doctor they are able to be discharged. For those who need complex health and social care support the team has achieved a 67% improvement in the time patients wait to be discharged, reducing the average waiting time from four to one and a half days. This reflects a huge improvement in supporting people to leave hospital as soon as safely possible, and to the right place of care.

Nigel Lee, Chief Operating Officer at SaTH, said: “As soon as a patient is deemed medically fit, there should be no delay in getting them home. Any hour spent in hospital without needing to, is an hour too many.

“The team is proud to have worked together bringing expertise from all areas of health and social care practice to establish the integrated discharge hub for the patients of Shropshire, Telford & Wrekin and mid Wales. The aim was to improve the process of getting people home, reduce bed capacity when it’s not needed and to enhance patient experience. We have certainly done that, and we will now be looking to how we can embed this into our ways of working for the future, beyond COVID-19.”

Claire Old, Senior Responsible Officer for Discharge said “All our staff have recognised how important it is to help our patients to return home as quickly as possible, and they have worked so hard to facilitate this. Our patients and relatives have also been part of our team and have understood the constraints of the Covid pandemic. Our community teams, local care homes and domiciliary agencies have pulled out the stops to support our patients when they get back home or to their normal place of residence. We’ve all be so proud to be part of this caring health and social care system.”

Mike Carr, Deputy Director of Operations at Shropshire Community Health NHS Trust, said: “At Shropcom, we were fully committed to this important initiative, and redeployed colleagues from a variety of services to create this enhanced discharge offer for patients. Now we must all look at how we can build on this together over the weeks and months ahead as we look to shape healthcare beyond the pandemic. Our desire is to take the positives from this crisis and develop our services accordingly.”

Tanya Miles, Assistant Director, Adult Social Care and Housing, at Shropshire Council and Sarah Dillon, Director Adult Social Care at Telford Council, said: “Both Local Authorities are really excited to be working as part of this initiative with our health colleagues. We are committed to getting the best outcome for patients, and this new way of working puts patients at the centre of our activities and promotes true person centred outcomes. The Integrated Discharge Hub has given us the opportunity to move beyond organisational barriers, and develop a new way of working that maximises opportunities for collaboration with our partners and give better outcomes to patients, their families and their carers.”