Improving the speed and ease of hospital discharge - Kent County Council

Promising models of care – case studies

Kent County Council realised that over half of the service users that they supported in residential placements had come via an acute hospital. In many of these cases, an improved discharge process putting in place an appropriate care package could have facilitated an earlier, safe return home – which was the service users’ preference. A process for discussing specific cases in daily hospital team meetings was developed and social care discharge coordinators were introduced to provide support and challenge to their colleagues.

The revised process improves the speed and ease of hospital discharge by enabling early identification of people who can be safely supported outside the hospital. A ‘reablement approach’ can then ensure that they achieve maximum independence. This process has clear benefits for the person and produces benefits for the local authority and the hospital by ensuring that the person is discharged to the most appropriate care setting in a timely manner. The local authority is expected to benefit from a reduction in higher-cost care packages and care home placements and the hospital is expected to benefit from fewer delayed discharges.

Current use and benefits in Kent

Most people who use the service in Kent are aged over 65.

Early evidence suggests there has been:

• 36% reduction in short-term placements for over 65s
• 34% reduction in long-term placements for over 65s
• £4.1m saving

Potential benefits in Birmingham

The evidence from Kent suggests that there could be a reduction in the cost of long- and short-term adult social care placements of approximately 13 per cent.

This could result in potential savings, per annum, in Birmingham of:

• £4.2m in long-term placements
• £490,000 in short-term placements

Implementation issues

One of the biggest challenges to rolling out the Kent approach is the complexity of implementing the required change management process. Behavioural change can be difficult to achieve when there is resistance due to differences in historical working practices and a lack of trust between team members.

The change process can be facilitated by ensuring that experienced team members and managers are part of the design and implementation of the new process and by ensuring that sufficient back-fill resource is provided to cover time allocated to the process. Embedding new ways of working requires additional intensive support from respected social workers who are prepared to challenge the status quo. Clear success measures are required to ensure that goals are being achieved.