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Staying out of hospital

Through our SupportUHome initiative with health partners, we are ensuring people can return home from hospital quickly and safely with the right support for themselves, their families and carers.

2017/18 priority: Reducing the number of delayed transfers of care from hospitals

A delayed transfer of care is where someone spends unnecessary time in hospital because they don’t have arrangements in place to go home safely or to move to a more appropriate care setting.

In 2017/18, local partners were set challenging targets by Government to reduce Delayed Transfers of Care. We achieved these targets in September, and even got a mention on BBC’s Newsnight for our ‘marvellous work’.

In April 2017 Solihull residents spent 454 days in hospital where they didn’t need to be there. By September, we had to reduce this to 75 days in the months. This has subsequently increased slightly, but is still well below 2016/17 levels. 

In the coming year 2018/19:

  • We are looking to create a new discharge liaison support post
  • We will be reviewing integrated discharge and reablement services
  • We will work with residential and nursing providers to support timely discharge, and where people need care at home, we will provide incentives to care providers to arrange same day discharge where appropriate

Find out more:

Leaving hospital - George’s story

George is an elderly gentleman who spent time in hospital in November following a hip fracture.

Three weeks after being admitted to hospital, he was ready to be discharged, but he was lacking confidence around how he would manage at home.

The ward staff & the hospital social worker discussed the situation with George, and arranged for George to move to a ‘Discharge 2 Assess’ (D2A) bed in a local nursing home.  This would enable George to access rehabilitative support, and to make longer-term choices away from the hospital environment. It also freed up the hospital bed during a period of high demand.

While George was at the nursing home, the D2A Therapy Service worked with him around his mobility and confidence, and visited his house to look at possible options. George remained concerned about stairs and isolation. He didn’t want to just live downstairs.

George’s social worker suggested that moving to an Extra Care Sheltered Scheme might  enable George to retain a degree of independence, but with support on site when required. The social worker supported George to apply to the extra care scheme of his choice, and to arrange a flexible package of support around meals, household tasks and personal care. George was offered a 1 bed flat, with in-house support suitable for his needs.

Before George moved in, D2A Therapy visited the flat and provided some aids and adaptations, including a pendant to wear which would alert staff if he fell, and through which he could call for assistance. George’s family helped with furnishings.

George moved into Hampton House at the end of January, after two months in the nursing home. Due to his more suitable living environment, and the support he has in place, it is less likely that he will need to return to hospital.