Housing’s Role in Quicker, Successful Hospital Discharges
Workshop Purpose • A bit about Home Group • Bed Management and Discharge Facilitation Team (BMDFT) • Commissioner feedback • Hospital Discharge Facts and Figures • Measuring outcomes • Case studies • Workshop activity • Barriers to Hospital Discharge • Resources
Home Group • National Registered Provider • General needs social housing • Care and support division (Stonham) • Supported housing, community-based support and CQC registered provision • Client groups • Client needs
Bed Management and Discharge Facilitation • Pilot in three mental health hospitals in Norfolk • Commenced in 2012 and extended since • Overall reduction in length of stay, reduce number of occupied bed days and reduced readmission rates • Support Coordinator role • Integral part of the ward team • NHS Information Governance • Small caseload with intensive casework • Positive risk taking • Non-clinical intervention • Supported by Home Treatment Team in the community
Commissioner Feedback ‘Sarah contributed and liaised with other agencies, to make referrals, and time consuming (especially for people who aren’t familiar with procedures, requirements and appropriate forms) complicated actions to aid patient’s discharge. The role helps to ensure appropriate socio-economic position of people recently discharged from acute mental health services, supports their confidence and prevents relapse of their condition due to everyday worries’ – Staff Nurse ‘I would like to thank you for all your support and work that you have put into this referral and safeguarding this individual from homelessness. It’s really great to see good partnership working between agencies’ – Service Coordinator ‘The team brings a great work ethos, enthusiasm and, professional approach to their work, clear communication flow to often very, very busy and stressful environment’ – Staff Nurse
Hospital Discharge Facts and Figures Bed blocking costs the NHS £900 million per annum in the UK. Housing Association Charitable Trust (HACT) Social Value Tool The HACT tool estimates the potential social value of services that address well- being. Examples of annual savings to statutory/public sector funding per individual include: - Relief from depression/anxiety = £35,563 - Improvement in confidence = £11,470 - High confidence = £13,188 Monitor , the Health Service’s financial regulator, stated that NHS providers, predominantly hospitals, overspent by £930m in three months, putting it on course for an annual deficit in 2015/16 of at least £2 billion, in what they described as its ‘worst financial crisis in a generation.’
Measuring Outcomes – Quality of Life Quality of Life At the beginning of service - - At the end of service Control over own life Dignity Personal care Food and nutrition Occupation Accommodation Social participation Safety
Measuring Outcomes – Quality of Life Quality of Life Entry point Exit point Difference % Indicators Control 2.00 1.82 -9% Personal care 1.50 2.27 52% Food and nutrition 1.25 2.45 96% Accommodation 1.25 2.09 67% Safety 1.25 2.09 67% Social participation 1.38 2.09 52% Occupation 1.13 2.00 78% Dignity 1.50 2.18 45%
Measuring Outcomes – Wellbeing
Measuring Outcomes – Wellbeing
Case Studies • These case studies all relate to the Bed Management and Discharge Facilitation team, working with mental health clients. • The challenges remain similar for any individual being discharged from hospital, whatever their health needs may be.
Workshop Activity Discuss in small groups: a) Opportunities for housing organisations to work more effectively with health services. Why should we be involved? b) Initiatives you are currently aware of supporting people recently discharged from hospital or preventing unnecessary admissions. c) Challenges that you as social landlords and housing providers may face.
Barriers to Hospital Discharge • Developing relationships with Health professionals – language. • No support at home – more and more of the population live alone. • Broken relationships and lack of support networks leading to social isolation and fear of living alone. • Lack of timely coordination of knowledge of care and support provision which could be set up around the individual. • Lack of step down provision for people who no longer have acute needs but are not well enough to return home. • Finance and welfare benefits – money worries. • Digital exclusion for older people and those with complex needs. • Other barriers?
Resources Housing LIN ‘Quick Guide: Discharge to Access – Transforming Urgent and Emergency Care Services in England’ September 2016 http://www.housinglin.org.uk/Topics/browse/HealthandHousing/HospitalCarePathways/?p rent=8687&child=10282 The King’s Fund report: ‘Social Care for Older People’ September 2016 http://www.kingsfund.org.uk/publications/social-care-older- people?gclid=CIDjzMLP0s8CFRQTGwodVcYECQ Parliamentary and Health Ombudsman Report of Investigations into Unsafe Discharge from Hospital http://www.ombudsman.org.uk/__data/assets/pdf_file/0005/36698/A_report_of_investigatio ns_into_unsafe_discharge_from_hospital.pdf NICE Guidance to Improve How Community and Hospital-based Staff Work Together https://www.nice.org.uk/guidance/ng27/resources/improving-how-community-and- hospitalbased-staff-work-together-to-ensure-coordinated-personcentred-support- 2600430445
Thank you Jo.huxtable@homegroup.org.uk 07889 087017 Chrissy.chalmers@homegroup.org.uk 07715 001992
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