Hospital Discharge An Age UK Perspective

1. Hospital DischargeAn Age UK Perspective Alan Carpenter Chair Age UK Bristol

2. Summary • Hospital discharge tends to focus on medical fitness and survival ADL, with minimal social care support. • What might really prevent many admissions and thousands of delayed discharges are active communities that support the practical and clinical needs of older people in the longer term. • A good quality discharge needs both high quality discharge procedures and criteria AND really good support (often practical) around peoples’ homes • These hardly exist- but may be the only game in town and must be a priority for CCGs too. (Better Care Fund)

3. Key thoughts • From discharge from hospital- to transition back to home and community? • Vital importance of clinical and practical support around home- as core – not a fluffy add-on- even for “simple needs” A rounded approach to the whole process • New approaches- Leeds and Birmingham

4. Common experience Discharge is often focussed on present medical fitness and survival activities of daily living (ADL) BUT NOT Wider longer term practical and social support Which are also fundamental!

5. We need • Community infrastructure to provide practical and social support- complementing social care and using local resources (Circles of care) • A recognition that this would have a huge impact on acute admissions and discharges (7-10%) • This to be jointly commissioned by Health and Social care- with the 3rd sector. www.nesta.org.uk

6. Wider perspective Older people who are more unsupported, inactive and purposeless are: • More likely to be depressed • More likely to seek GP support frequently • More likely to be admitted to hospitals • Less likely to live independently after discharge http://www.campaigntoendloneliness.org/

7. Case study A local volunteer helps Maud into hospital, looks after her house and pets, and visits her. She also helps to explain the care plan and options to Maud. She then supports Maud’s discharge, takes her home and provides practical support afterwards, including daily visits, shopping, help after falls and so on. Maud’s circle of care provides her with activities and ongoing support- including befriending and some personal care. Imagine what normally happens and ask yourself where your patients are one day, week and month after discharge?

8. Summary • Hospital discharge tends to focus on medical fitness and survival ADL, with minimal social care support. • What might really prevent many admissions and thousands of delayed discharges are active communities that support the practical and clinical needs of older people in the longer term. • A good quality discharge needs both high quality discharge procedures and criteria AND really good support (often practical) around peoples’ homes • These hardly exist- but may be the only game in town and must be a priority for CCGs too. (Better Care Fund)