The right intervention, at the right time, in the right place…

Stephanie Robinson is an occupational therapist at Harrogate hospital working as the  frailty team leader across the medical elderly wards and previously seconded into the Supported Discharge Service. She has had a key role in cross boundary working, outreaching from frail elderly inpatient based wards to the community.

The right intervention, at the right time, in the right place… How Harrogate District Foundation Trust therapists from the community and in-patient wards are tackling the national bed crisis: piloting a Supported Discharge Service.

The pressure is on in Harrogate – the population of over 60s is 26.5% compared to 22.4% nationally.  By 2030 the district’s over 65 population is predicted to increase by 15,000 people.  One of the Trust’s strategic aims for the next five years is to integrate acute, community and social care to allow patients to be treated closer to home, or at home and reduce reliance on acute beds.  It is understood that therapy assessments completed in a patient’s own home are a more accurate reflection of their capabilities than those completed in the hospital environment.  Based on the Discharge to Assess model, the concept that the hospital is often not the most appropriate place for patients of any age to remain is not a new one.

Closing acute hospital beds for older people – the way to save our services?

Prof David Oliver is a Consultant Geriatrician in Berkshire and a visiting Professor in Medicine of Older People at City University, London.  He is President Elect of the British Geriatrics Society.

At the recent King’s Fund Integrated Care Summit, I shared a speaking platform with David Prior – the new Chair of the Care Quality Commission and a man of experience and sincere commitment to improving patient care. In the course of his talk, he stated that “far too many patients are arriving at hospitals as emergencies, with accident and emergency departments out of control and unsustainable in many parts of the country.”  He added that “the healthcare system is on the brink of collapse” and “if we don’t start closing acute beds and investing instead in community care, the system will fall over”. He stated that with “almost half of hospitals providing care which is either poor or not terribly good,  the pressure means that regulators cannot guarantee there will never be another care disaster such as Mid Staffs”.