Innovative hospital discharge model at NHS trust frees up 60 beds per day

Care management software provider CareLineLive has expanded its partnership with Mid and South Essex NHS Foundation Trust (MSEFT) that is resulting in freeing up 60 beds per day of patients that would otherwise remain in hospital awaiting discharge.

MSEFT began dealing with bed blocking in 2016 via a “Bridging Service”, where it started to provide short-term domiciliary care services directly to patients leaving hospital while waiting for the local authority to commission a longer, more sustainable care package. Between April and December 2022, this service alone resulted in 11,500 saved bed days.

Building on the bridging concept, the trust pioneered a more holistic service in June 2022 called the Southend Enhanced Discharge Service (SEDS).

SEDS is a Discharge to Assess (D2A) service that provides a complete therapy-led hospital discharge assessment at home for Southend residents rather than an assessment being provided by the hospital before discharge.

It enables patients to leave hospital sooner with appropriate provision of care at home, including provision of any essential assistive technologies the individual may require to become independent.

Physiotherapists and occupational therapists are involved in assessing patients in their own home. This has also led to significantly more efficient triage to appropriate community-based services than previous systems, according to CareLineLive.

John Walter, General Manager of Integrated Care at MSEFT, said: “In early 2022 a large number of Southend residents were delayed in Southend Hospital waiting for their social care package to start, totalling 570 lost bed days each month.

“Since October 2022, thanks to SEDS, this has now been significantly reduced down to 270 bed days meaning our patients are getting home quicker to recover and the hospital has more beds available for those who need it. We still have a way to go to bring this to zero, but it shows that SEDS is making improvements and moving in the right direction.”

Between June and December 2022, SEDS resulted in 5,070 saved bed days, which, combined with the Bridging Service, gave a total saving of 16,570 bed days.

The projected saving for the year April 2022-March 2023 is predicted to be around 22,000 bed days, equating to 60 beds per day.

In Southend, every hospital discharge for patients requiring a new package of care is via SEDS. This includes patients who may be at risk of falling at home and people with reduced mobility.

SEDS delivers the immediate home care that is required, and then therapists assess each patient once at home, working with them and collaboratively with social services and the wider multi-disciplinary team to determine their ongoing care needs.

Within 14 days, 12-15 percent of patients are discharged with no ongoing care, 40-50 percent are discharged into reablement services, and 30-35 percent are discharged into longer term social care, according to CareLineLive. In the two-week period, 25-30 percent of all patients recover to the point that their level of care can be safely reduced, highlighting the important benefits of post-discharge therapy and care, the provider highlights.

SEDS has been developed in partnership with MSEFT and Southend Council and works closely with other health and social care partners across South East Essex.

CareLineLive provides the underpinning care management software that manages the home care services. CareLineLive is an easy-to-use home care management system that digitalises operations, such as rostering client visits, and eliminates the need for paper-based administration.

As the provider’s software can be accessed from any internet-enabled device, it meant that MSEFT was able to expand its bridging service during the height of COVID-19, despite restrictions on office-based activity.

John concluded: “CareLineLive has helped us take our service into the 21st Century. It is a fantastic electronic record solution for any service that has a need for remote patient care in the community. It enables staff to work remotely, document remotely and be scheduled electronically. It has enabled us to improve efficiency, capacity and reimagine patient care.

“CareLineLive is a great solution if you want to be more efficient, transform your services and future proof your ways of working and delivering patient care. It helps services be more sustainable, be more GDPR compliant and mitigate against data issues. It is also scalable and functions in real time so we always have an up-to-date assessment of what is happening with each patient.”

In January 2023, NHS England issued guidance to integrated care boards (ICBs) about how they should use the £200 million discharge fund to free up vital bed space in England.