Hospital to Home
Digital Discharge to Assess – Simply, Safely & Securely
THE D2A CHALLENGE
The challenge of safely discharging people from hospital is a national issue reliant on gathering and continually sharing/updating information from separate, unconnected systems. It requires a multi-agency approach involving hospitals (ward staff, doctors, discharge teams, pharmacy services et al), CCGs, adult social care teams, local authorities, transport providers, domiciliary care providers and others.
The updated Discharge to Assess (D2A) model was introduced in March 2020 in order to simplify and speed up hospital discharges in light of Covid-19. Since its introduction D2A teams across the country have been using all means possible – heavily relying on spreadsheets, email and the telephone – to support the safe discharge of patients.
SOCIAL CARE DIGITAL INNOVATION ACCELERATOR 2020/21
The aim of the SCDIA is threefold; to engage councils to co-design and co-fund solutions to shared Adult Social Care (ASC) challenges; to focus on priority issues that are unmet by the market; and to develop real working solutions that can be scaled across local government and the wider public sector.
D2A was a clear candidate for the SCDIA after numerous councils cited it as a challenge that desperately needed a digital approach. Starting in August 2020, five councils co-funded and co-designed a solution as part of the Social Care Digital Innovation Accelerator 2020/21 (SCDIA), which was run by CC2i on behalf of the Local Government Association, and which benefited from NHS Digital match-funding.
Subject matter experts from North Lincolnshire, Southend, Sutton, Herefordshire & Birmingham began by detailing their D2A challenges and then for the next six months were guided by the technical partner – Maldaba – who scoped, designed and developed a solution that met their varied – and quite complicated – requirements.
HOSPITAL TO HOME (H2H)
Hospital to Home offers case management and tracking functionality, allowing users from multiple organisations to create, update and track D2A cases through an open, human driven workflow. The platform supports the D2A process from the point at which a person is identified on the ward as requiring support on discharge, through to the point that the person receives an assessment on their longer term needs within a community setting.
H2H joins-up the work between acute trusts and social care for people being discharged, in a manner that simply is not currently otherwise possible. All stakeholders are able to securely log-in from anywhere, and see/update patient information in real time. H2H offers management reporting that would otherwise take us hours of wrangling data, to understand D2A pathway performance.
“Hospital to Home provides the one version of the truth. It’s really stimulated a different conversation. We’re having system conversations now because everyone can see the right information, at the right time, they can see progress, so that people are discharged home safely.”
Wendy Lawtey, Head of Adult Social Care and Performance, North Lincolnshire Council
Hospital to Home is a great opportunity and genuine improvement. There are so many advantages of Hospital to Home. All sorts of cost benefits, but I see those as a by-product. If there is one version of the truth – and all partners have access to it – it gives a greater understanding and avoids confusion that can sometimes happen particularly when people are working under pressure”. Luke Addams, Assistant Director of ASC, LB Sutton
“The introduction of H2H has really helped us, it’s a really active, live system. Lists have been the bane of our lives in D2A, now there are no delays in paperwork, it gives us – and partners – all the information we need to ensure someone is home and that they have been assessed and that their needs are being met safely.”
Kelly Siddons, Head of Adult Social Care and Performance, North Lincolnshire Council
The video below gives greater insight into H2H from the subject matter experts involved.
Alongside the platform and information governance framework, a business case was worked up around the H2H model and the benefits it will bring to councils and their health and care partners.
Savings and efficiencies are significant; in the case of North Lincolnshire – one of the collaborating councils – H2H is estimated to deliver an annual saving of £72,000 purely from administrative savings, with the wider health economy efficiency savings of £85,000 and a further circa £250,000 savings in terms of releasing hospital bed capacity (per annum).
This 8 minute video outlines the key features of Hospital to Home, the process, patient and business benefits councils are experiencing: