The RCN Discharge planning guide (2010) state that ‘Care transfer is an essential part of care management in any setting and it bestows responsibilities on organisations, systems and individuals. Smooth and effective care transfer ensures that health and social care systems are proactive in supporting individuals, their families and carers. It also ensures that resources are used effectively. Timely care transfer requires clinicians and others to plan, inform and negotiate to ensure a smooth transition for individuals and their families. Underpinning this is the need for early identification of discharge/transfer dates including pre-admission planning, effective communication between individuals and across settings, good clinical management plans and the alignment of services to ensure continuity of care’.
However it often seems that this ideal is difficult to achieve due to pressures on both Health and Social care systems. As a result the number of days hospital bed managers have to keep people in hospital beyond their discharge date (because they cannot be transferred into the community safely) has risen by nearly 20% in a year. NHS England statistics show that in the past 12 months there have been 1,042,434 bed days lost due to patients being unable to be discharged in a timely manner. This is an increase of 19% on the previous year’s 873,415 lost days and cost NHS England £287m.
The problem facing the health service is about making sure patients who are medically fit to leave hospital can recover in the right place, and therefore their acute beds are made available to others who need them. Physiotherapists may be ideally placed to facilitate effective care transfers; we are key health care staff who often bridge the boundary between primary and secondary care as well as being involved in innovative in- or outreach programmes to support discharge home.
So – What can we do? How can we Help? Will this ever change? Join in this #physiotalk on 25th January at 8pm (GMT) to discuss the issues around effective discharge planning.
Pre-reading
- Inpatient Admissions and Bed management in NHS acute hospitals
- Sky news report
- Safe Hospital Discharge study report
- A summary of the Department of Health’s guidance Ready to go?
Questions to consider
- What is your understanding of Discharge Planning?
- What is a physiotherapist’s role in planning discharge, what are your experiences? Can we do more?
- What are the risks or dangers if discharges are not planned correctly?
- Are doctors, nurses and therapist well informed about discharge planning for their catchment area?
- If we are moving towards continued community care, should there be more specialised teams in the community to avoid readmission?
- As therapists what can we do to effectively plan a safe discharge?
Chat host
Nik is a recent graduate from University of Leicester. He says: I am now a Band 5 Physiotherapist working at The Barts NHS Trust in the Emergency Therapy Team. Due to the nature of my role I have been heavily involved with patient discharges which has made me realise what an important subject Discharge planning is, and how a physiotherapist can influence a safe and effective discharge.
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