We want as many as possible to be discharged home, which is the best place to support their recovery. Some might need intermediate care before they can be fully independent, but it is safer and more effective for it to be delivered in the community.

There is no one-size-fits-all solution but there are three non-negotiables:

1. Patient and carer-led design. Understanding the concerns and frustrations of patients and carers is vital to designing a model of care that works for them. Conducting lived experience surveys has helped us identify opportunities to drive change that makes a difference to real people.
2. Joint working between health and social care providers. Effective care happens inside and outside hospital and relies on a network of organisations –NHS providers, care homes, local councils and voluntary care sector organisations. By working together and building trust, colleagues from different organisations can get patients to the right place more quickly.
3. A joint vision, supported by joint governance. When health and social care organisations work as a system, they can get the right capacity and funding in place to meet the needs of patients. This requires joint commitment to the same goals and leadership to support its delivery.  

How to get started?

It's complicated to transform discharge processes and improve the provision of intermediate care but we’ve seen many examples of where changes have been transformative. Here are some useful steps to get started:

• Map patient pathways to understand specific bottlenecks in existing processes and opportunities to improve
• Learn from patient and carer feedback to understand frequent issues on the ground and what’s really important to them
• Define a joint vision for discharge, including joint measures for success and a new model of care that makes the most of providers in hospital and in the community
• Implement pilots to test and adapt new elements of the model, foster trust across organisations, get on to doing quickly and learn as you go
• Develop a collaborative for voluntary and community sector organisations who can help support patients in the community
• Build the savings case for investment in improving discharge and intermediate care provision - integrated working and high-quality services provide better value
• Forecast demand and capacity requirements for services in hospital and in the community, so they are fit for the future

The PSC are committed to supporting our clients with these steps. For every extra patient discharged successfully, one more person and family can be confident that they are further on their way to recovery and independence.

The PSC Transformation team

The PSC exists to make public services brilliant. Our collaborative approach is focused on creating meaningful and lasting change. We work together to analyse and diagnose your situation, devise a programme of support, then help make it happen. If you would like to talk to our Transformation team about how we might support your work on improving hospital discharge, please contact: hello@thepsc.co.uk