Patients avoid 7,500 nights in hospital with ‘tailored’ home help scheme

An NHS programme in Somerset has helped patients avoid 7,500 nights in hospital and freed up at least £2 million for other services.

Somerset’s pioneering ‘Homefirst’ scheme offers patients who are healthy enough, and their families, tailored help to finish therapy at home, with personalised care reducing stays in hospital by up to ten days.

Described by health leaders as ‘a common sense approach’, Homefirst is delivered by specialist teams of staff who have been given additional training in a range of care techniques, so they can do more with patients once they are home, to help them regain independence faster.

The NHS’ long term plan, unveiled this week, set out how care will be increasingly integrated across communities, with different health services, councils and other agencies working together to provide faster, more convenient and more joined-up care within each community.

In Somerset, instead of waiting to complete assessments, such as walking the ward, in a busy unfamiliar place, people for whom it’s safe to do so can be discharged home at the right time and get support for important tasks, based on their home and enabling a quicker and happier recovery.

The team see patients on the wards at both Somerset’s acute hospitals, involving families about when a patient is ready to go home and liaise with medical and nursing staff to ensure patients are comfortable and happy that they can be discharged safely.

Tim Baverstock, who led the scheme for Somerset County Council, said: “We’ve found that all it can take to avoid a long hospital stay is a frank conversation with the patient and family to learn more about how they can manage at home and their wishes.

“If someone starts to recover they often want to go home and previously paperwork and assessments could have meant waiting weeks. But while the patient waits their mobility and independence reduces and causes frustration – a person over 80 who spends 10 days in hospital loses 10 per cent of muscle mass equivalent to 10 years of ageing. We wanted to bring an end to that.”

Across the NHS, 14 Integrated Care Systems (ICS) and many Sustainability and Transformation Partnerships (STP) are seeing NHS and local government join forces to pool resources and budgets and simplify systems for the patient across primary and secondary care.

The Homefirst Scheme is within Somerset STP and is an example of this integrated working.

Dr Karen Kirkham, NHS England’s National Clinical Advisor for Primary Care, said: “As we deliver on the long term plan for the NHS, it is common sense schemes like this which are being rolled out across the country to get the best care for patients and make the best use of every penny. By finding out more about a patient’s circumstances at home we can tailor the care they get.”

Mr Baverstock added: “We’ve been working closely with hospital and social care colleagues to transform the culture so decisions are about personalising care, talking to families and setting up the right support as fast and as close to home as we can.”