As part of a national programme designed to help people return home from hospital as quickly as possible, University Hospitals Plymouth (Derriford) and Livewell Southwest have launched their own ‘Homefirst’ discharge pathway.
This pathway is an ongoing integrated venture with involvement mainly from the general medical wards at UHP, Livewell Southwest’s DTA (Discharge to Assess) Team, our Reablement partners and the NHSi collaborative – improving patient flow initiative.
We are able to provide a service where a person (who is identified as appropriate for the Homefirst pathway) is met within two hours of discharge home for their assessment. All goals, rehab and care needs are assessed and planned for in their own home.
This is based on the belief that home is always the first option to be considered in the discharge process, hospital is not the best location to determine the support someone needs at home and that arranging care from hospital can extend a person’s time in hospital and often uses more of the domiciliary care hours.
The Discharge to Assess Team (DTA) is made up of social workers, nurses, physiotherapists, occupational therapists and support workers. They work closely with colleagues in UHP and locality teams as well as our reablement provider (Human Support Group). The service provides time limited, goal driven reablement to support maximum independence being achieved. This pathway is currently in its early stages but will continue to develop and thrive with the integration of UHP and Livewell services over the coming months.