‘Home first’ – Joy’s story

Joy, 94, was admitted to Hillingdon Hospital following a bad fall at home. A referral to ‘Home first’ meant that she was home two days earlier than she would have been before this new way of working.

One in three patients sat in a hospital bed today, are medically fit to leave the ward. In North West London we are working to ensure that our patients return home from hospital as soon as medically fit, with the right support in place.

To tackle this, North West London clinicians, social care providers and local voluntary organisations are piloting a new approach to the hospital discharge process.

This new way of working called ‘Home first’, is being piloted across all four major NHS trusts in North West London over summer 2017.

For every day an older patient stays in a hospital bed, they can lose 10 per cent of their muscle strength because they are not following their usual routines. ‘Home first’ aims to reduce length of stay for elderly hospital inpatients and reduce their risk of requiring residential care. Elderly patients have their health and social care needs fully assessed at home rather than while they are still in hospital, with additional support in place at home if required.
 

Meet Joy

Joy, 94, a retired charity volunteer, was admitted to Hillingdon Hospital following a bad fall at home.

A referral to ‘Home first’ meant that she was home two days earlier than she would have been before this new way of working started.   

Following Joy’s return home the rapid response team visited her within two hours. They assessed Joy’s abilities in carrying out daily activities such as: washing and dressing, and getting around the house, and provided her with equipment to aid her at home.

Someone from local charity Age UK accompanied Joy home. Joy tells us: “It was decided that it would be better if I slept downstairs so they moved the bed downstairs for me; they provided a commode and put a new seat on the downstairs toilet.”

Other services that helped Joy include social services, physiotherapy, and a district nurse. She continues to receive regular visits from physiotherapy to help build back her confidence and independence in her own home. 

Dr Daniel Sommer, specialist in older people’s care and ‘Home first’ project lead said:
“As a doctor specialising in the care of older people, it is incredibly frustrating seeing my patients unable to return home as soon they are ready to do so. With ‘Home first’ I am really excited to know that patients will be able to leave the ward when they are ready and that we can provide real support to aid their recovery at home.”

Joy adds: “I am very happy, this experience has been unexpected and overwhelming but I am eternally grateful for the help that I received.”
 

Why is ‘Home first’ better for patients?

On average, patients who are medically fit to leave hospital could be back home three days earlier. ‘Home first’ benefits patients as getting them home faster reduces the possibility of catching infections and getting pressure ulcers. Getting patients home as soon as they are well enough also aids recovery and the likelihood of going back into hospital.

Alison, Joy’s daughter comments: “It was certainly exhausting for mum with all the different people coming in and out of the house but I don’t think there is any way around this for the level of service provided. Being in your own home is definitely better than being in hospital as you can begin to regain your life. There has been a great continuation of care.”
 

Hopes for the future

‘Home first’ will allow North West London’s NHS to use resources more effectively by providing the support patients actually need to recover at home, rather than trying to fit them into existing standard packages and procedures.

Hospital wards will run more smoothly, with more beds available for planned operations and reduced waiting times for patients who need emergency care.

‘Home first’ challenges our old way of doing things. We are extremely happy that NHS, local council staff and voluntary organisations are on board to help us ensure that patients and their carers have an overall better recovery and experience.

Similar schemes elsewhere in the country are already operating with great success, leading to speedier recovery times for patients and greater levels of satisfaction.

Click here to have a listen to Dr Daniel Sommer talking about 'Home first' and Joy's story.