We need to go back to basics to enable people to go home from hospital sooner

We know that the NHS is currently experiencing the most challenging period in its history. With COVID-19 still looming, a massive elective surgery backlog and a struggling care market, there are long queues to get into hospital and long waits to get out.

While we recognise that there are issues with the operating and funding model – and that we will struggle to shift that model in the coming months – the sector must focus on what can be done now to achieve better outcomes. Getting people home sooner to enable the flow throughout the hospitals. We can see, feel, and hear this through our work with frontline teams in hospitals.

Our Valuing Home work with frontline teams has highlighted the need to go back to basics – understanding what we are really trying to achieve when we discharge patients from hospitals:

• Placing them with or near to their families and friends
• Recognising how they were, and what they were capable of, before they entered the hospital
• Enabling them to be independent, by implementing a strengths-based approach to build their confidence, and finding out what really matters to them and their recovery

The frontline staff we work with every day want the best for their patients, and they make every effort to achieve this. Yet the push-pull nature of their day-to-day jobs makes quick and easy decision-making a routine. They don’t have the time or headspace to think differently, making it challenging to move away from default approaches to a re-occurring problem. We know this because we see the constant churn of flow, and this can leave the staff feeling burnt out.

A high proportion of patients are placed into care homes when they could be at home with an intensive package of care or technology enabled care (TEC) instead. By not thinking outside of the ‘norm’, we risk moving away from the desired outcome: enabling people to be independent and at at home.

In our work, and as highlighted in our ‘Age of Intermediate Care’ report lco-produced with the Association of Directors of Adult Social Services we challenge this risk-averse culture by supporting staff to think differently. For example:

Thought: this person might fall if they don’t have 24hr care

Reframed thought: what does this person need in order to walk independently again?

We must focus on the positive benefit of sending them home with extended support, instead of going to a care home as the default option. This requires a strengths-based approach within assessments and conversations to find out what they can do, not only what they can’t.

We know patients want to be at home, and that being at home is better for their wellbeing. We know that getting patients home with the right support (to enable their independence) will lessen the dependency and increase their capability. And, we know that this is at the heart of the Home First approach.

It starts with small steps. Small steps that can have a great impact. Creating a positive vision for change, going back to basics, and reframing how we think about our day-to-day challenges. This can then become embedded into day-to-day frontline delivery that will get people home sooner and empower independence. To find out more about IMPOWER’s Valuing Home work, please get in touch.