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Passing on the expertise

08 March 2013

Health Care

Southend University Hospital has been commended for the way it ensures patients leave hospital safely and speedily once they are well enough.

Before the introduction of the 2003 Community Care (Delayed Discharges) Act, the average length of time it took to discharge a patient after a doctor had pronounced them fit enough to leave hospital was 14 days. Prior to this, a few even stayed in hospital a year while suitable arrangements were put in place for them. Apart from the expense, this naturally had an impact on the number of beds available for new patients. Now, thanks to close cooperation with social services, rehab therapists and the hospital's 'home from hospital' team, the delay has reduced to just over two days.

Southend's success was praised by the NHS Emergency Care Intensive Support Team who made a two-day visit to the hospital last month (February) and have now asked discharge manager Sandra Steeples to pass on her expertise to other hospitals.

Sandra said: "Most other hospitals have two or three discharge coordinators; we have nine. You really need one coordinator for every three wards.

"We also 'spot purchase' beds in a number of residential community homes for patients recovering from an acute illness where we provide rehabilitation."

Each day, Southend's discharge team produces a list of patients who are medically fit to leave hospital, based on information relayed electronically from the wards. The list is shared immediately with social services colleagues to enable them to get care packages in place where needed.

Sandra, who developed the system, believes it is exclusive to Southend and adds: "It pulls all the information together. Without it, we would not know where to start.

"The team deals with patients who need help from social services, rehab or have other complex needs and aims to discharge all patients on the day they are pronounced medically fit to leave."

Sandra has already helped other hospitals to speed up their discharge procedures, in one instance saving the NHS Trust more than £1m in one year. Now the Emergency Care Intensive Support Team has asked her to share her methods still further.

They include ensuring orthopaedic patients have the necessary home support to allow them to leave hospital in their plaster casts (one hospital kept them in for four to six weeks), and liaising closely with colleagues in pharmacy to speed up preparation of the medicines patients need when they go home.

Sandra's team also holds weekly teaching sessions for doctors, nurses, therapists, students and social services to instil the need for safe and timely discharges.

She said: "The team works so hard. We are all senior nurses and have to deal with some very difficult and confidential situations "


With pic; Sandra Steeples, discharge manager