Hospital Discharge: Discharge to Assess Beds
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This enter and view to care homes formed one part of a Healthwatch East Sussex programme of work related to the wider issue of discharge from hospitals. This project is specifically about a scheme entitled ‘Discharge to Assess’ (D2A).
Discharge to Assess is a national default model for the NHS. Under D2A schemes, planning, assessment, and arranging ongoing care, takes place in the D2A setting rather than the hospital.
Healthwatch East Sussex visited ten care homes and met with 25 residents funded through the D2A scheme. All visits were carried out over a two-week period starting from week beginning 27 January 2025.
All people met with stated their admission to hospital was unplanned, with many experiencing a fall or accident at home. Therefore, none had anticipated being in a residential setting, with many stating their preferred option would be a return home. Some recognised their situation had changed dramatically and reluctantly accepted they may require long term residential care.
It was unclear what rehabilitation services and support people received whilst in hospital. However, people had mostly been in hospital for lengthy periods of time, even up to a year, and so their motivation and abilities to self-care had been reduced.
The information provided by hospitals to care homes as part of the admission process was often inadequate.
The majority of people referred through the D2A scheme remained in long term residential care.
The chances of a person being able to return home were increased where there was an allocated social worker for the care home who worked specifically with the residents placed through the D2A scheme. They had contact with the person soon after their admission and worked proactively and effectively with the care home, the person and their families to obtain the best outcome for the person.
Linked with the above, social workers were able to access rehabilitation services quickly compared to situations where there was a delay in allocating a social worker and a delay in identifying and arranging relevant rehabilitation services for the person