SPH was commissioned by a CCG to evaluate a ‘Discharge to Assess’ initiative aimed at reducing the secondary care inpatient length of stay of elderly frail people who no longer have any medical needs. Home First is the name given to these Discharge to Assess schemes that aim to safely support the transfer and short-term recuperation of elderly people home. Once people are at home and have recovered as much as possible of their day to day functioning they can be assessed, if necessary, for on-going home care or transfer to residential care. The evaluation SPH undertook was based on a mixed model of quantitative and qualitative measures. It provided a number of functions including:
- Providing a detailed understanding of all aspects of the initiative for commissioners
- Linking the original strategic objectives of the initiative with the day to day experience of people providing the service in managerial and operational roles and the challenges they face
- Linking the original strategic objectives with activity and cost of the initiative
- Recommending improvements and a plan for future evaluation
The key outcome of the evaluation was to inform the commissioning of the service in the longer term and identify immediate actions needed to strengthen the service in the short term in order for it to play a significant role in easing winter pressures at the local hospital NHS Trust.
For a more in depth look at the rationale behind Home First schemes see this article published by The Guardian on 10 October 2017: https://www.theguardian.com/social-care-network/2017/oct/10/home-first-model-aims-to-stop-patients-being-stranded-on-hospital-wards
The Local Government Association website signposts to national guidance and some examples of local initiatives: https://www.local.gov.uk/our-support/our-improvement-offer/care-and-health-improvement/systems-resilience/overall-approach/discharge-to-assess