Right care, right place - transforming hospital discharge across North West London

Right care, right place - transforming hospital discharge across North West London
posted 20 April 2017

How can we improve hospital discharge processes to deliver better and more effective patient care? Over the past years, PPL has worked in close partnership with the West London Alliance (WLA) to address this challenge. Our hospital discharge integration efforts are changing lives across North West London and the work has gained recognition as one of the most effective change programmes across health and care in the UK.

We are proud winners of the Patient Experience Network Awards in the Inclusion of Social Care category and of the Institute for Continuous Improvement in Public Services Awards (Overall Winner). Additionally, the programme is also selected as a finalist at the 2017 MCA awards and MJ awards, and will be presented at two upcoming international conferences, including the 17th International Conference on Integrated Care.

This is what the PEN and ICiPS judging panels have said:

This is an incredible submission - both in the way it has been presented but also in the achievement. A tough challenge on so many fronts but it appears this Alliance has managed to overcome the many obstacles with impressive results that will make a significant difference in the outcome for people like Charlie.’ (PEN)

‘The award was made as we felt the project was a patient driven initiative that demonstrated collaboration and innovation and delivered quantifiable benefits for all involved.’ (ICiPS)

Joe Nguyen, PPL’s Associate Director, has been managing the programme with the West London Alliance for the past two years and he says: ‘Obtaining this recognition is a really important milestone for the programme. We are proud about the difference this makes to health and care in North West London, and to the many people who have already benefited directly from the changed ways of working. This is truly an achievement for integrated care and our results to date are down to focused efforts and joined up working by the WLA team, managers and front line staff alike, from health, social care and commissioning organisations.’

The hospital discharge programme started with the design of an integrated hospital discharge model in the local authorities of Westminster, Kensington & Chelsea and Hammersmith & Fulham, as well as across Chelsea and Westminster Hospital and Imperial College Healthcare NHS Foundation Trusts. At this stage, these organisations agreed on a shared approach to hospital assessments. As a result, a single integrated cross-borough hospital discharge team started completing all discharges for these boroughs’ residents across North West London.

In a second stage, the programme expanded to the neighbouring local authorities of Hillingdon, Harrow, Hounslow, Brent and Ealing. It also included London North West Healthcare and the Hillingdon hospitals, for a total of:

·         8 local authorities;

·         8 CCGs;

·         4 hospital trusts and 8 hospital sites; and

·         3 community providers.

PPL involved stakeholders from all these organisations, across professions and seniority levels, in the co-design and co-production stages of the model of care. The involvement of staff through all stages of the programme means that the model of care, the implementation and the outcomes reflect the needs and wishes of each locality. This work focused on co-locating health and social care teams, designing shared assessment forms and policy principles, and drafting joint working agreements to support the IT integration.

PPL’s approach has also taken into account the impact of the changes on staff. This is why we designed a bespoke learning intervention, to support the discharge teams in the new ways of working. Over 100 hospital discharge staff attended our training programme in Autumn 2016 and more will benefit from it during 2017.

The programme is still ongoing and expanding: the organisations involved have agreed to sign new information sharing agreements to support effective and prompt communications. There now is a shared operational approach to hospital discharge in North West London.

Importantly, the positive impact of the new model of care has been recognised by the staff involved, as well as the judging panels quoted above. A Medical Consultant at St Mary’s Hospital said about the programme: ‘This is one of the few projects that I have witnessed in a long time that has actually improved patient and carer experience, promoted true multi-disciplinary working and has reduced length of stay in the hospital – we need to roll this out across every single ward.’