HSJ Awards 2014: Secondary Care Service Redesign

Heart of England Foundation Trust, Birmingham City Council and Solihull Metropolitan Borough Council: Supported integrated discharge

The judges described the project as “a patient-centred approach to organisations working together, to bridge the community and hospital pathway, offering integrated care”.

This project reorganised the way the trust and local authorities support patients discharged from the acute hospital, to cut down the length of their stay and return them to maximum independence, while making significant cost savings.

Targeting emergency admissions of over 65s, the project used acute therapy staff and city council re-ablement staff working in partnership to create a seamless transition between an acute setting and a supportive community based health service.

The service model included up to 14 days of therapy at the patient’s home from the acute trust, along with a re-ablement programme from the local authority. Ongoing therapy was handed over to community therapy services if needed.

The result was a 13 per cent drop in over 65s staying in hospital more than 14 days, and an average four-day reduction for those staying longer than 14 days.

Bed reductions have saved about £2.5 million, compared with the £700,000 needed to operated the supported integrated discharge model. The patient was also less likely to need ongoing long term care.

The approach at the Birmingham Heartlands Site is now being developed on the Solihull Hospital Site with similar results.

Other finalists’ programmes:

• Nottingham University Hospitals Trust – Development of the outpatient parenteral antibiotic therapy (OPAT) service
• Aneurin Bevan Health Board – Adult weight management service
• Croydon Health Services Trust – Ambulatory emergency care at Croydon Health Services
• Hambleton, Richmondshire and Whitby Clinical Commissioning Group – Redesign of paediatric and maternity services at the Friarage hospital
• Lancashire Teaching Hospitals Foundation Trust – Patient-focused antibiotic treatment
• North East Lincolnshire Clinical Commissioning Group – Short stay paediatric assessment and observation unit in A&E
• Royal Infirmary of Edinburgh, NHS Lothian – The Kaizen Chiefs
• Sheffield Teaching Hospitals Foundation Trust – Front door response team
• The Leeds Teaching Hospitals Trust – New care model saves more lives
• The North West London Hospitals Trust – The St. Mark’s CT colonography team promoting early diagnosis of bowel cancer