Hospital discharges: tackling the issue in Wigan

Featured article - 19 April 2017
By Rebecca Murphy, Healthier Wigan Partnership Director

We’re proud of this stat: in 2016-2017, we helped 81 more people to be discharged directly home from hospital rather than into residential care with our integrated discharge team. This might seem small beer. But we want residents to be able to remain at home, with a smooth discharge from hospital and the right services wrapped around them. We are tackling the challenge of delayed discharges of care in Wigan by working together.

• SCIE: Better Care Fund support and guidance

It’s all part of the Wigan Integrated Discharge team’s passion about reducing the number of patients who have completed their medical treatment, and are ready to be discharged. But it’s not just us. It’s a ‘whole systems approach’ which, translated, means bringing together staff from a range of organisations and managed together in one place to provide a joined-up response for our local population.

Teamwork is vital

The team includes discharge coordinators from the hospital, district nurses from our integrated community services team and domiciliary care services. Also, housing colleagues are involved, as is the homeless service, along with reablement staff, social workers, social care officers and mental health workers.

Now, the integrated team has one manager, who has to be a strong leader and also has to be trusted by all of the partner organisations involved. They are, in turn, supported by a social care manager in the team. This role is crucial to make sure that the process of discharge is managed as one system. So, for instance, there’s one referral system and one reporting system that all staff use. This means that:

• everyone has access to the same information
• disputes about data are prevented – there aren’t sets of discharge information and data flying around
• provides real-time information that’s updated three times a day and reviewed by the team
• a complex case panel looks and prioritises the response to complex cases.

Staff from the integrated team also go into the hospital wards to develop good relationships with staff there, to build trusting relationships and to ensure consistent practice takes place. They are able to support each other if there are any pending delays and they are also able to call upon support from community services and other areas of the system quickly to manage pressures.

This all means that the team have collective responsibility for the discharge of patients, with contributions from a range of different professionals with different expertise. This can build trust, can encourage strong relationships and can encourage shared responsibility for solving problems. And this team has improved transfers of care in Wigan; and we’ll continue to look at ways of extending this and improving even further.