New initiative helps patients get home from hospital this winter

Date: 27 January 2020

HART team

A new initiative that was trialled at the Horton Hospital in Banbury has been helping more people regain their independence and get home quickly and safely.

The Home Assessment Reablement Team (HART), a multi-disciplinary team who provide care and support to patients when they leave hospital, are working on a therapy-led ‘discharge to assess’ initiative which is aimed at people who do not need to stay in hospital, but who need extra support in the short term to enable them to go home. 

The initiative helps identify these patients earlier, meaning they spend less time in hospital and are then assessed in their familiar home environment to help plan for both their short and longer-term needs.

Some of the support HART offers includes enabling independence in daily life, like helping people to learn to wash and dress independently again, and cook their own meals.

Following a trial at the Horton General Hospital last year, the initiative is now also underway at the John Radcliffe Hospital and has now been rolled out across Oxfordshire.  Part of a Trust-wide programme with a focus on continuous improvement, the initiative will help support patients through the winter months. 

To date, HART staff have supported over 600 patients through the ‘discharge to assess’ initiative.  Over 480 of them have since been discharged from HART’s care, with over 50% of these people now living fully independently following their treatment, and the other patients receiving ongoing support in the community.

One Banbury patient who was treated by the team said: "The team really went out on a limb for me – they really could not have been kinder.  They always had a smile on their face and couldn’t do enough for me."

Sam Foster, Chief Nursing Officer at the Trust, said: "This initiative is a really wonderful development for our patients.  The work the team do is so valuable, and by changing the location that we make decisions about on-going care needs to a person’s own home rather than in a hospital ward, we can make sure more people are confident and happy in their homes following discharge from hospital.

"Once hospital care is complete, many people want to be back home as soon as possible, which is completely understandable.  Being in hospital for longer than needed often leads to a deterioration in people’s general condition, and can even increase their long-term care needs.

"By helping people regain their independence and continuing our 'home first' approach, the team can continue to deliver safe, effective care and support in the most appropriate and often happiest setting for our patients."

Stephen Chandler, Director of Adult Services at Oxfordshire County Council, said: "We’re delighted that HART at Oxford University Hospitals NHS Foundation Trust have taken this new 'discharge to assess' approach forward, and we were really pleased to recently offer them a 'Good' accreditation.

"Patient safety and care is at the heart of all that our organisations do, and by bringing treatment closer to home we can make sure that patients are happier and more confident in their own environment, which is an essential part of a successful recovery."

Pictured: just some of the HART staff helping patients home this winter pictured with Chief Executive Officer Dr Bruno Holthof.

  • Summary:

    600 patients have been helped under the scheme.

  • Transformation:
  • Date:
    27 January 2020