A new service improvement tool has just been launched across Kent, Surrey and Sussex, to help NHS Commissioners, Integrated Care Boards and health and care providers improve their discharge to assess pathways, helping to reduce hospital stays, provide rehabilitation and improve the assessment of a patient's long-term care needs.

The toolkit follows an evaluation project carried out by NIHR Applied Research Collaboration Kent, Surrey and Sussex (ARC KSS); Kent, Surrey and Sussex Academic Health Science Network (KSS AHSN); and Unity Insights, as part of the Accelerated Access Collaborative NHS Insights Prioritisation Programme (NIPP), funded by NHS England.

It follows discussions with directors from the three Integrated Care Systems across Kent, Surrey and Sussex, that revealed how the discharge from acute hospitals was a key area of concern.

Commissioners, social care staff, staff from primary and community health services and colleagues across the voluntary and community sector were then interviewed from across three Health and Care Partnerships (HCPs): Dartford, Gravesham and Swanley; East Sussex; and Surrey Downs Health and Care Partnerships (HCPs). This ensured a mix of rural, coastal and urban environments, levels of deprivation, life expectancy and ethnicity. Literature from Healthwatch organisations and Carer's UK was analysed to understand the service user and carers experience of discharge.

The evaluation identified three core themes that stood out as a priority:

  • Commissioning: how the service is financed; the structure and culture and the outcomes the services are working towards.
  • Multidisciplinary working: how the services in the pathway connect, the skills and knowledge of the team and how care is coordinated along the pathway.
  • Information and knowledge exchange: how service users and carers are assessed and communicated with, how the information is managers and flows between the teams and how the path is overseen.

Leading the evaluation, Stuart Jeffery, Senior Research Fellow, ARC KSS and the University of Kent, said:

“During the first wave of COVID-19, the government provided emergency funding to support a new Discharge to Assess pathway. This successfully provided a mechanism to reduce hospital stay, provide rehabilitation, and improve the assessment of a person’s long term care needs.

“With continued pressures on discharging people from hospital, we were keen to understand and evaluate the processes and barriers across social care, primary and community health services, and the VCSE sector, as well as the experience of service users and their carers.

"Understanding the enablers and blockers to the smooth running of a successful D2A pathway enabled us to develop a service improvement tool, with input from health and care providers, commissioners and also members of the public. Central to our evaluation, we recruited a patient advisory panel to provide support for the co-production throughout the evaluation and to make sure, from the outset, that the service user and carer voice was heard and understood."

Download your free, Service Improvement toolkit

Access the full reports from the D2A project website

Download short read summary

Watch our short video outlining the project and the key findings

Download presentation slides from the D2A launch events

For further information on the D2A programme contact: This email address is being protected from spambots. You need JavaScript enabled to view it..

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