by Sarah Farragher, Home First and System Flow Coordinator for Cumbria County Council, North Cumbria Clinical Commissioning Group and North Cumbria Integrated Care Foundation Trust
Welcome to the first transfer of care blog!
The purpose of these is to bring you up to date with all of the work that we have been doing as a system to make sure that we reduce the length of time people spend in hospital when and help people to return home. We want to celebrate the work that we have been doing together - North Cumbria Integrated Care NHS Foundation Trust, Cumbria County Council and NHS North Cumbria CCG - to improve outcomes for people and the next steps in our journey together. We have made some great improvements in they way we support people but have more to do to reach our ambition that 95% of people who leave hospital return home rather than transferring to alternative bed based services.
Update on Discharge to Assess
In October 2020, we started a new process called discharge to assess (D2A). People who would have previously remained in hospital for on-going therapy and assessment where enabled to have these assessments in their own environments with a back up of returning to hospital if this was unsafe. To date approximately 1000 people have been supported through a D2A and over 90% of these people have remained at home with equipment and or support that is appropriate for their needs. This is a credit to the joined up working between our acute and community staff across health and social care.
NEW Transfer of Care Hub
In March 2020 we agreed to invest in our integrated discharge teams and develop these into a fully integrated health and social care transfer of care hub. We have now recruited Paul Carruthers as the manager of this team and Paul is taking up post from the 1st July. We will update on the implementation of the Hub as it progresses.
What good looks like for discharge
Over the next few weeks we will be running some focus groups to capture views from staff, providers, and citizens on what good looks for discharge as part of the development of a quality assurance framework - further details are available here...
Showcasing North Cumbria’s success
The Local Government Association (LGA) have commissioned a video to showcase the work that has been done in North Cumbria. They are keen to include pictures of people being supported to return home from hospital. We need to make sure we have the appropriate permissions for this so if you contact your comms team we can make sure people can record their permission appropriately. The timescales for this are the end of July so we really need your help to show the positive work here in North Cumbria!
That’s all for now, watch this space for future updates...