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It is often difficult to predict how a person’s care needs are likely to change over time. Care, particularly for those with long-term illnesses or perhaps those in their later years, can be an ongoing journey. However, there are also those who require care for only a short space of time. They may still be recovering from an operation or illness, for example.
What does Discharge to Assess mean?
Commonly known as ‘home first’, ‘step down’, or ‘safely home’, The Department of Health, in their Quick Guide: Discharge to Assess defines the Discharge to Assess model as: “Where people who are clinically optimised and do not require an acute hospital bed but may still require care services, are provided with short-term, funded support to be discharged to their own home (where appropriate) or another community setting”.
“Assessment for longer-term care and support needs is then undertaken in the most appropriate setting and at the right time for the person.”
According to Professor Martin J Vernon, discussing the importance of the Discharge to Assess (D2A) scheme for the NHS, it is “a pragmatic approach of reducing delays in hospital. This will lead to improved experiences for some of the most vulnerable people we care for.”
Due to the onset of COVID–19 in March 2020, there was urgent pressure on the NHS to free up as many as 15,000 beds for the anticipated influx of admissions as a direct result of the virus.
Many hospitals closed their doors to all but emergency care with government guidance directing the immediate discharge of all patients considered clinically ready.
During this time, the Discharge-to-assess scheme really came into its own with the process of assessment to take place in the community after a patient is discharged from the hospital.
Earlier this year, the government announced that the scheme would be the continued standard for discharges from acute hospitals in social care.
It is thought that, in keeping with the 2015 NICE guidelines, the scheme will aid “the transition between inpatient hospital settings and community care home settings for adults with social care needs.”
An example of where the Discharge to Assess scheme has proven to be a resounding success is the Medway NHS Foundation trust.
According to NHS England, the headline outcome was a 25% reduction in delayed transfer of care (DTOC) across the first three months with a positive experience reported by both patients and staff.
One of the most important elements of the transition, as reported by the Trust, was “ Do not underestimate the significant engagement and communications which need to take place to enable systematic changes.”
Coordination and careful person-centred care planning led by community Discharge to Assess teams, patients and families have played a critical role in ensuring that the Discharge to Assess scheme is as seamless and as efficient as possible.
The NHS and Berkshire Healthcare have created the video below which explains the Discharge to Assess Scheme really well:
Challenges relating to Discharge to Assess
As successful as the scheme is, it’s not without its own set of challenges.
One of the largest is the transition to information technology systems. Many areas are embracing technological solutions, like Qwikify, to reshape how care is delivered and how information is recorded and exchanged.
The aforementioned Medway has adopted hand-held mobile devices to create care plans and undertake assessments and referrals.
In addition to overcoming the challenges faced by the NHS to successfully adopt the Discharge-to-assess model, community settings such as the residential care home sector have also needed to overcome their own challenges in adopting the model.
Under strict Clinical Commissioning Group’s (CCG) contracts, care homes are tasked with ensuring that all Discharge to Assess patients receive the highest level of person-centred care expected by any long-term patient or resident.
However, many homes continue to use the traditional paper-based care planning solution. The time taken to create and maintain these records and the short-term nature of the Discharge to Assess placements places a high administrative burden on care staff. Records may therefore be incomplete or only completed when the discharge from the care home is already in discussion or even begun.
An Electronic Solution for Discharge to Assess Teams
Many care homes have therefore taken the decision to integrate an electronic care planning solution within their homes.
Barriers regarding the ability of care staff to transition to digital care records have been addressed with modern platforms that can adopt consumer-level user experience (UX) design, making them incredibly user-friendly and staff are able to be up and running in very little time and with minimal training.
Qwikify allows users to use its very simple interface to create a full set of person-centred care plans in less than 15 minutes meaning that the time it takes to complete is reduced significantly by up to 90%.
If you would like to find out more about the Discharge to Assess scheme or how transitioning to an electronic care planning tool can help you, please drop Qwikify a line by clicking below.