Discharge to assess with HomeLink Healthcare. Retaining the positive improvements from the pandemic

While Covid-19 has thrown much of society into disarray and caused monumental damage to hospitals, healthcare workers and their patients – in healthcare, there have been some positive changes. One of these is in the altered attitudes toward hospitals and home-based care. Another is in the rapid rollout of crucial services that ease pressure on hospitals and make for better patient experiences. At HomeLink Healthcare, we believe it is essential that these changes remain – pandemic or not.

Aims of Discharge to Assess home-based services

Attitudes towards hospitals have been shifting for some time. Historically, both doctors and patients operated under the belief that the patient was best cared for in the hospital. This led to extended stays; the remedy for any illness, a hospital visit; prolonged periods in the ward even after a patient was fit to return home.

Covid-19 was the catalyst of a new way of thinking: avoiding hospital admissions in the first place where possible; getting people home faster in every other case.

For patients, in the heightened context of the pandemic, fear and avoidance of hospitals has become widespread. Numerous statistics underpin this. For overstretched and overburdened healthcare workers, the ability to relieve beds for urgent patients is critical.

The UK government has also taken note. In 2020, Discharge to Assess (D2A) was launched in hospitals across the country. The aim? To discharge all patients who no longer met ‘acute criteria’ as soon as clinically safe to do so, and where possible, to avoid hospital admission to begin with. Assessments take place at home, rather than at hospital. It has been found to not only be possible, but beneficial.

At HomeLink Healthcare, we provide D2A as part of our home-based services, It is an integral part of how we work and our ethos as an organisation.

HomeLink’s D2A Service at The Queen Elizabeth Hospital King’s Lynn

We were pleased to partner with The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust (QEHKL) to create a harmonious D2A service to improve patient flow in their wards and reduce capacity challenges. Being a small and agile company brings a number of advantages to our partnerships. We are able to set up and deploy supporting services rapidly: our D2A with QEHKL was one of the quickest services we’ve ever delivered, with just a four week mobilisation period until it was fully up and running, using the NHS SBS Patient Discharge Services framework for procurement and contracting was essential to achieve the tight timescales.

For patients, that meant we could get many of them back home for Christmas. Since then, we have rapidly ramped up the service, and it continues to go from strength to strength. We were one of the first homecare providers to flex our services to accept Covid-positive patients. A core element of how we work is as a bridge organisation: not replacing existing systems or provisions but complementing and enhancing the care provided. That means all our services are bespoke, moulded to the needs of the particular hospital. Whether we’re providing increased capacity or improving the efficiency of processes, we align ourselves with existing hospital and community practices as much as possible. And as a small company, we can do that efficiently, cost-effectively and most importantly; safely.

Key to this is open, transparent and supportive communication. At QEHKL, this meant visiting the wards or speaking with the therapists, building rapport with the therapy-leads, frequent team and stakeholder meetings, and giving constructive feedback on how patients were progressing and any issues encountered.

Similarly, we ensured we made positive connections with the community therapy teams; reiterating that we exist to fill the gaps, not replace their services. We recognise the strain they are under and their huge waiting lists – so how could we best complement that service and really place patients at the centre? Now, if the community team has patients that need to be urgently seen and they are unable to support, they send them to us, knowing we can assess them in 24 hour and feedback any recommendations or provide the input required.

In the words of Tim Rees, Professional Lead Occupational Therapist at The Queen Elizabeth:

“HomeLink has been a marvellous asset to our service at the hospital. Their therapy team has worked seamlessly with our therapy teams in the development of the Discharge to Assess model. The communication, expertise and support they have brought to the project has been invaluable. The feedback has always been positive and non-judgemental which has fostered team spirit rather than creating an atmosphere of them and us.”