Derriford Hospital
An innovative partnership between Carehome Selection and Plymouth Hospitals NHS Trust has delivered major benefits for both the hospital and patients.
As a result of the scheme, 20 to 25 patients each month are safely cared for in the community rather than in Derriford Hospital, says Dr Steven Allder, Consultant Neurologist at the Trust.
“It makes the difference between us hitting the four hour A&E target rather than failing it,” said Dr Allder, who is Clinical Director for Neurosciences. “It is that important".
“The management of complex elderly patients is key to the operation of the whole hospital.”
The scheme focuses on areas where there are traditionally delays in discharge or inappropriate hospital admissions because other care is not available.
Carehome Selection arranges interim community care for hospital patients facing delays in their placement and patients who attend A&E because they need more support but do not require hospital admission.
Support and advice is also offered by Carehome Selection advisers for hospital patients who need to move to a care home, making the process work more quickly and efficiently.
Dr Allder, Head of Clinical Service Improvement for the Trust, explains: “A reduction of 20 to 25 patients a month is equivalent to a whole hospital ward.
“It is fair to say that Carehome Selection have really helped us prove how important complex elderly patients are to the operation of the whole hospital.
“As a result of this scheme, we have a different case mix on our wards and the appropriate number of nurses for that case mix,” said Dr Allder.
The innovative scheme was introduced in Derriford Hospital in December 2006. An audit carried out by the hospital during the previous year had found at any one time, there were approximately 53 patients in the hospital facing delays of six days or more in their transfer to community care.
The scheme has reduced the length of stay for patients in the scheme by between 7 and 14 days.
“The set up of service has been impressive,” said Dr Allder. “Carehome Selection has integrated into the hospital without any operational problems and the feedback from clients has been very good.
“Before working with Carehome Selection, we had not appreciated was how much work is involved in the process of arranging a placement; the many different transactions which are necessary to get a patient placed.
“We knew we needed to focus on the interface between the hospital, social services and care homes, but we didn’t have the resources for it.
“We brought in Carehome Selection because they had the experience of this role and we have been able to hold them to account for their results.
“Carehome Selection have been fantastic. They have proved undoubtedly that 20 to 25 hospital patients can be safely cared for in a non-acute community setting at any one time.”
Dr Richard Newland added: “This is a great example of the way Carehome Selection can work with hospitals to solve a major problem.
“An audit had shown that at any one time, a significant number of patients were experiencing a delay in their discharge.
“Yet we found that in the immediate area around the hospital, 235 suitable interim care beds were available.
“What was lacking was a system for linking the hospital patients to appropriate community based care.
“The solution enables the hospital to focus on the patients who need acute care and is far better for patients, who are able to receive the support they need in a community setting.”