Journal of Palliative Care & Medicine
Open Access

Abstract

Background: With increased delayed discharges from acute NHS hospitals, especially for older patients, solutions like the discharge to assess (D2A) scheme aim to facilitate quicker discharge and improve experiences for patients and carers. Once patients are identified as medically fit, the D2A scheme supports patients to be discharged home or to another community setting where they have their care and social needs assessed and provided for. During this period of rehabilitation, the patient�s longer-term continued care needs can then be assessed in a more appropriate environment and at the right time. Setting: This report examines the quality process from the patient perspective of the D2A scheme (now re-named Home First) implemented by a team in a London Northwest Healthcare NHS Trust (LNWHT). A retrospective audit was conducted using the first cohort of patients discharged through this pilot scheme from April to July 2017. Question: A brief study to explore patient views of their experience of the D2A scheme; to detect any change in their perception between what was agreed and what was delivered; and to explore how the discharge process might be improved for patients. Methods: An opportunistic audit comprised of brief telephone interviews with patients following discharge from hospital through the D2A scheme. Results: 30 patients who had been discharged with the D2A scheme, agreed to participate in the evaluation exercise. Overall, patients were positive about their experience and valued the support and services provided. However, there were concerns on the issue of communication, which caused some patients to be concerned. The scheme effectiveness from the patient�s perspective improved over the duration of the evaluation. Discussion: Patients' views about their experiences changed over time, which included patients' perceptions of the discharge process, patients' expectations and the way in which they were able to access services.

Biography

Lucy Meehan is an Imperial GP trainee working in Northwest London, England, and is pursuing a GP specialist interest in healthcare of the elderly in primary care. She has worked with Dr Ricky Banarsee and public health colleagues to evaluate patient experience of an innovative scheme, discharge to assess, which aims to improve hospital discharge and provide rehabilitation and social support in the community, once older patients are deemed medically fit. By focusing on qualitative evaluation of patient experience, this offers greater insight into the patient journey through the discharge scheme and offers suggestions for improvement. As she trains to be a GP and with a special interest in healthcare of the elderly, schemes such as discharge to assess are widely welcomed to address current NHS issues such as delayed discharges from hospitals and managing the aging population in the community.

E-mail: lucy.meehan@nhs.net