health & social care
local government
2

Ensuring Patient Safety Through Effective NHS Discharge

health & social care

local government

08:45 - 16:30

Tuesday 15 October 2019

Central London

Early Bird Discount Offer

10% off all advertised rates for a limited time only. Discount available to public / voluntary organisations only.

 

This Forum will give participants the opportunity to discuss best practice case studies with key policy leaders and clinicians involved in NHS discharge. Attendees will learn about the future of discharge practices and the incorporation of new data and technological insights, whilst gaining an understanding of how regulation systems can be used to maximise potential benefits and ensure efficient but safe discharge practices. Delegates will learn from innovative case studies from across the UK and practical networking opportunities will ensure that participants gain insight and knowledge about solutions to challenges relating to discharge practices.

Audience

This Forum is designed specifically for the NHS and Local Authorities. Typical job titles will include:

  • Heads of Integrated Discharge Management
  • Discharge Coordinators
  • Long Term Care Leads
  • Heads of Quality and Adult Safeguarding
  • Clinical Operations Directors
  • Directors of Nursing
  • Consultants
  • Integrated Care Leads,
  • Service Improvement and Efficiency Managers
  • Continuous Health Care Leads
  • Community Nurses
  • Senior Nurses and Matrons
  • Emergency Care Leads
  • Patient Flow Coordinators 
  • Integrated Transfer Leads
  • Discharge Project Leads
  • Partnership Delivery Leads
  • Innovation Heads
  • Strategic Planning Officers 
  • Care Home Managers
  • Heads of Adult Social Care
  • Transformation Managers and Patient Champions
Key Speakers Confirmed:
  • Professor Martin Vernon, National Clinical Director for Older People and Person-Centred Integrated Care, NHS England
  • Jo Beer, Director of Integrated Care & Partnerships, University Hospitals Plymouth NHS Trust
  • Dr Khai Lee Cheah, Consultant Geriatrician, Royal Free London NHS Foundation Trust
View the agenda and additional speakers

Despite significant improvement since 2015, latest figures from NHS England indicate that there were 135,700 total delayed discharge days across the NHS in January 2019, of which 86,800 were in acute care. Discharge without adequate social care support has led to Citizens Advice estimating that a fifth of a GP’s time is spent on problems with non-medical causes.

Delayed discharge is especially important in the case of elderly patients suffer from unnecessarily extended stays, delays of over 10 days leading to the equivalent of 10 years of muscle ageing for those most at risk. With an ageing population likely to increasingly rely on NHS services, safe and efficient discharge processes must be established and maintained to reduce potential future risk for the NHS.  

In an attempt to improve discharge pathways, NHS England developed the ‘Discharge To Access’ model, seeking to improve coordination and communication between overlapping service providers. The National Institute for Clinical Excellence (NICE) has published guidelines on discharge processes, whilst the introduction of Care Quality Commission (CQC) discharge inspections has provided an impetus for regular staff training, coordinated care networks and greater patient-led care decisions. The provision of the Better Care Fund (BCF) was designed to join up health and social care programmes, so that local partners can work in tandem to access funds to promote efficient transfers of care, shifting resources away from hospital services and towards community-orientated care. Finally, the Government has provided increased funding to support adult social care, with a £2billion increase in 2017 and a further £240 million in October 2018 supporting the goal of the 2019 NHS Long-Term Plan to further reduce delayed transfers of care (DTOC).

Yet, the Home To the Unknown report by the Red Cross has argued that these initiatives have not gone far enough, and that too many people are discharged without a full assessment of their situation at home. They have called for a fuller assessment using physical, social, psychological, practical and financial factors and for increasingly joined-up care between local government and health care to ensure better support for patients as they require it. 

If the NHS is to cope with a rise in demand amongst patients requiring short, intensive hospital care with appropriate discharge processes to support recovery, it will need to continue to improve discharge pathways to free up valuable resources and ensure that patients receive the comprehensive care they require. Improving pathways, collaborating better with social care services and reviewing internal procedures will be crucial to ensuring the NHS overcomes challenges involved in discharge. 

08:45

Registration, Refreshments and Networking


09:30

Chair's Welcome Address

Dr Lucy Meehan, Clinical Research Fellow, Imperial College London (invited)


09:40

Interactive Session: Setting the Scene and Having Your Voice Heard

The day will begin with a 20 minute interactive session, led by the Chair, in which delegates will be able to ask questions, raise their key concerns and inform the Chair of what they would like to discuss during the course of the day.

This will inform debate and direct the conversation throughout the day so that attendees are confident that their most pressing concerns and desired learning objectives will be covered. 


10:00

Morning Keynote: Achieving Integrated Care for Older People

  • Outlining the challenges and opportunities faced in creating effective and safe hospital discharge pathways, including the need to support cross sector collaboration which focuses on time sensitive discharge planning processes
  • Sharing guidance from the NHS England & Improvement NHS Long-Term Plan Ageing Well programme, including personalisation of the care journey to achieve improved experience and outcomes of care
  • Exploring how policy initiatives set out within the Ageing Well programme will be used to support achievement of  NHS targets focused on length of stay and delayed transfer of care reduction, and how new government investment in primary and community services aligns to this
  • Discussing future policy avenues which can support national NHS ambitions to deliver tailored and integrated care which makes sense to older people, those with complex needs and their families and carers

Professor Martin Vernon, National Clinical Director for Older People and Person-Centred Integrated Care, NHS England (CONFIRMED)


10:20

Case Study: Exploring Practical Approaches to Patient Discharge Procedures Through the Same Day Emergency Care Programme

  • Highlighting how the Same Day Emergency Care will improve patient care for elderly patients to reduce unnecessary hospital stays 
  • Discussing the Royal Free Care Homes Outreach Programme which aims to improve the patient care for older people through proactive care planning 
  • Outlining the success of this programme in reducing emergency hospital stays for care home residents and how this was enhanced by training the workforce in care homes 
  • Exploring how Royal Free London NHS Foundation Trust has implemented a Triage Rapid Elderly Assessment Team (TREAT) to help assess, diagnose and treat patients without hospital admittance

Dr Khai Lee Cheah, Consultant Geriatrician, Royal Free London NHS Foundation Trust (CONFIRMED)


10:40

Questions and Answers Session


11:00

Refreshments and Networking


11:20

Case Study: Sharing Data to Support Safe and Efficient Patient Discharge

  • Outlining the successful implementation of a comprehensive plan to utilise data to support discharge, recognised in a nomination to the 2018 HSJ Healthcare Awards in the Enhancing Care by Sharing Data and Information Category
  • Discussing the collection and use of patient feedback to identify areas of discharge weakness and produce plans to improve recognised areas of weakness
  • Highlighting how the foundation uses data to effectively work alongside local authority and voluntary services as part of the ‘Home Safe’ discharge service, such as by passing on key at-home requirements and other important medical information before the patient has been discharged
  • Exploring how this will allow voluntary services and local authorities to be proactive, not reactive in providing out of hospital care 
  • Sharing best practice examples from Northumbria on the best use of data to support discharge, such as the Silverlink PAS system, a new electronic patient administration record across the hospital that improves the depth and availability of the key patient data required for discharge

Birju Bartoli, Executive Director of Performance and Improvement, Northumbria Healthcare NHS Foundation Trust (invited)


11:40

Case Study: Using Technology to Manage System Stresses Through Safe and Efficient Patient Flow

  • Sharing how taking an integrated, technological-based approach saw Derriford Hospital reduce delayed transfers of care from 7% of beds in 2017 to 2% in 2018
  • Exploring how the creation of a new central command centre combined tactical management oversight and hospital discharge teams to implement improved discharge pathways by strengthening inter-department working and improving data flows to key sources
  • Discussing the role of improved data flows to make informed decisions and direct resources to where they could make the most difference regarding discharge, achieved through using data insights from the command centre to react to specific requirements as they arise
  • Outlining how NHS healthcare professionals can best seek to research and implement best-practice ideas from both inter-UK and international examples to improve discharge processes, such as adapting the command centre approach from an American model researched by the Trust 

Jo Beer, Director of Integrated Care & Partnerships, University Hospitals Plymouth NHS Trust (CONFIRMED)


12:00

Questions and Answers Session


12:20

Structured Task and Discussion

  • This session will allow delegates to discuss challenges faced and to share experiences of improving discharge processes
  • Keynote and case study speakers will be on hand to listen, provide feedback and insight into some of the challenges faced to promote idea generation on effective discharge practices
  • Key insights and discussion points can be shared on the Sli.do app for later reference and discussion in networking sessions alongside forming a basis for questions and answers sessions 
  • All discussion points will be shared, collated and sent out to delegates after the event


12:40

Lunch and Networking


13:40

Special Keynote: Investigating Unsafe Discharge Practices To Improve Multi-Agency Learning

  • Outlining how the Ombudsman acts as independent watchdog to hold healthcare services accountable, explaining the key differences between that role and the CQC in mission and investigatory powers
  • Exploring the findings of the 2016 A Report Into Unsafe Discharge From Hospital and discussing whether the NHS has progressed towards improving on the challenges outlined in the report, such as patients not being assessed properly before discharge and patients being discharged without a home-care plan in place
  • Discussing best-practice methods of addressing key issues in discharge, such as creating a collaborative integrated approach, involving patients in their own care decisions and ensuring that discharge processes prioritises patient safety
  • Identifying how the ombudsman service can be used by healthcare, local government and voluntary associations to promote improvement in discharge processes
  • Highlighting how the Ombudsman provides recommendations and raises awareness of key problems within the process that may have not been considered internally  

Rob Behrens, Parliamentary and Health Service Ombudsman (invited)


14:00

Panel Session: Creating A Integrated Multi-Agency Discharge Pathway To Support Patient Recovery

  • Outlining the integrated ‘Home Safe Sooner’ initiative and how the co-partnership work of the NHS Trust, Local Authority and the Five Lamps Charity has contributed to a significantly smoother, safer and quicker discharge process in North Tees and Hartlepool
  • Discussing how each member of the initiative plays a role at different stages of discharge, from the Trust treating the patient and organising at home care, the Local Authority finding and providing social care and the Five Lamps Charity organising travel and everyday help at home
  • Highlighting the creation of an integrated discharge and frailty team to provide comprehensive and coordinated care, ensuring that post-hospital measures are put in place to support patients recovery, supporting efficient discharge practices 
  • Discussing the importance of creating a positive, communicative relationship between frontline staff and management to best create solutions to discharge problems

Jill Foreman, Senior Clinical Professional, North Tees and Hartlepool NHS Foundation Trust (CONFIRMED)

Victoria Ingham, ART/MDS Team Manager, Stockton-on-Tees Borough Council (CONFIRMED)

Claire Evans, Senior Social Worker, Stockton-on-Tees Borough Council (CONFIRMED)


14:30

Questions and Answers Session


14:50

Refreshments and Networking


15:10

Case Study: Integrating Approaches to Promote Safe and Efficient Patient Discharge

  • Understanding Buckinghamshire CCG’s approach to reducing delayed discharges through improving the integration and flow of discharge pathways, ensuring that different parts of the hospital worked efficiently together to reduce discharge time and improve coherence 
  • Discussing the benefits and challenges of the integrated approach taken internally by Buckinghamshire and how it has supported patient discharge by reducing the time it takes for the Trust to consider somebody ready for discharge 
  • Highlighting Buckinghamshire’s decision to implement a discharge plan from the start of a patients stay in hospital and to carry out additional assessments in a patient’s home, contributing to a reduction in discharge time by lowering the threshold for discharge whilst retaining a safety-first approach 
  • Exploring how Buckinghamshire CCG bought together a variety of different in-house services and external social care providers to effectively work together to create safe and efficient discharge procedures, reducing the burden on hospital services internally 

Louise Patten, CEO, NHS Buckinghamshire (invited)


15:30

Case Study: Improving Discharge Practices - The Journey from Special Measures to Outstanding

  • Outlining how Medway reformed patient discharge pathways to come out of special measures and significantly reduce delayed transfers of care, sharing guidance on overcoming challenges faced in the process to reach what the CQC 2018 Inspection Report rated as ‘outstanding’ discharge practice just three years after being in special measures 
  • Discussing the implementation of separate but interconnected schemes that created a safe and efficient discharge pathway, including Medway Home First and D2A Pathways, which aimed to improve discharge by reducing the amount of testing needing before a patient was considered discharge-ready and by improving communication between separate hospital departments 
  • Exploring the role of communication and marketing to engage staff, convey new systems and changes and build trust in staff by patients
  • Highlighting the need to create a single access point for discharge coordination and sharing guidance on creating self-improving discharge structures, with room for staff innovation and sharing of best practice

James Lowell, Director of Clinical Operations, Medway NHS Foundation Trust (invited)


15:50

Questions and Answers Session


16:10

Interactive Session: Reviewing the Day and Prompting Delegate Feedback

The day will end with a 10-minute interactive session, led by the Chair, in which delegates will discuss their key takeaways, raise questions for further discussion and inform the chair of what they gained from the day. 

This will offer a chance for reflection on the lessons learned from the day and direct further conversation outside the forum so that attendees feel confident that desired learning objectives and pressing concerns were covered and will support further professional work. 


16:30

Chair's Summary and Close

*programme subject to change


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