Agenda item

The Board considered a report of the Strategic Director, Adults and Community which informed Members of the outcomes of the project to develop and implement Integrated Hospital Discharge Teams across both Warrington and Whiston Acute Trusts.

The Board was advised that most people spend a very short period of their lives in hospital; their discharge followed a fairly predictable pattern and they usually returned home. For those people already in the care system, or for those who would need ongoing support when they leave hospital, discharge processes should ensure continuity of the right care in the right place the first time.  However, it was highlighted that achieving a safe and timely discharge from hospital was a complex activity. The pressure to discharge or transfer patients and release beds, together with a trend towards shorter lengths of stay, meant that there was less time for assessment and discharge or transfer planning.  Effective discharge and transfer planning was essential.

The Board was further advised that a couple of areas of concern had been highlighted in relation to the safe and timely discharge of patients from both of our acute hospitals.  Therefore a project group had been established, in 2009, across the wider partnership, including Halton Council, Warrington & Halton Hospitals NHS Foundation Trust (“WHHFT”), Whiston Hospital, NHS Halton & St Helens, NHS Warrington, St Helens Council and Warrington Council, Knowsley Council and Knowsley PCT.

The group, had been asked to review the current systems and processes in relation to Hospital discharges with the overall aim of identifying ways to ensure safe, timely and high quality discharges of patients with complex needs, whilst reducing average length of stay, excess bed days, re-admissions within 28 days and discharges direct to long term care.

It was reported that work carried out by the project team suggested that the current process was complex, that the existing system for supported discharge was highly complicated in that numerous teams and individuals could be involved in the process, and that Ward staff had to deal with very different systems across the different Boroughs. In addition, as the length of stay reduced and throughput increased, it became increasingly challenging for ward staff to navigate the discharge process in a timely manner. In addition, there was also duplication and hand offs and performance issues.

The proposal from the project group was that an Integrated Discharge Team be developed in each Hospital. The team would consist of employees from each of the partners organisations; Warrington and Whiston Hospitals, NHS Halton and St Helens, St Helens Council, Knowsley Council, Knowsley PCT, Warrington Council, Warrington PCT and Halton Council.

This team would operate as a single point of referral for all patients within the Hospital, irrespective of which Borough they were resident in, the persons discharge would then be planned irrespective of whether it was a health or social care discharge.

The integrated team would comprise of discharge workers, discharge team specialists and support staff, all working under a senior team manager. Staff would be drawn in from both Health and Social Care (within existing resources) to create a multidisciplinary team. The Staff within the existing teams would be integrated to form this single team.  However they would not be requested to change employers, a management agreement would be drawn up and signed off by all the partners.

            Following discussion Members requested that this item be reported again in 12 months’ time.

RESOLVED: That

1)     the report and comments made be noted; and

2)     the Board receives an update on the Integrated Hospital Discharge Teams in 12 months’ time.