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Carter Report

CHS Healthcare hospital discharge service is featured in the Carter report as best practice

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CHS Healthcare is cited in Lord Carter’s major report on NHS productivity as an example of best practice in hospital discharge.

The landmark report, Operational Productivity and Performance in NHS Acute Hospitals: Unwarranted variations, estimates every day, 8,500 acute beds are taken by patients who are ready to leave hospital but whose discharge is delayed. This costs the NHS an estimated £900 million each year.

In the report, Lord Carter urges hospitals to take “matters into their own hands” and set up their own systems for improving discharge, such as the work of CHS Healthcare in Dudley.

Lord Carter states: “During our discussions we found examples of where acute trusts have taken matters into their own hands by setting up their own arrangements for step-down care, or have entered into partnership with local authorities or the independent sector.

“The national strategy should encourage trusts to do more of this to find rapid local solutions to the problem of delayed transfers.”

The report highlights two examples of good practice, one being the work of CHS Healthcare in Dudley. The report states:

Some trusts are looking to dedicated support and brokerage to reduce delayed transfers of care. These services work personally with families and beyond the traditional care hours model to support people to move to a care home of their choice, step-down care or back into their own homes. For example CHS Healthcare has worked with the Dudley Group of Hospitals to halve the days spent in hospital by fit to discharge patients saving 995 bed days over four months, at a net benefit of £170,000.

The figures from the Dudley were produced by the hospital trust themselves, in their evaluation of the initial pilot of the CHS Healthcare service.

The pilot in Dudley ran from October 2013 to January 2014, resulting in a saving of 995 bed days, according to the trust’s report. Taking a bed day cost of £220 per day, this produced an overall saving of £220,890 during the pilot. When the costs of commissioning the service from CHS are taken into consideration, there was a net saving for the hospital of £170,490 in just four months.

Bernie Green, urgent care pathways lead for the hospital, who produced the evaluation, commented: “The CHS service offered in principle, similar to our capacity team, is different in the way they operate. CHS work beyond the traditional care hours model and offer individuals more of a personal input by visiting families in their own homes and organising and facilitating care home visits.”

CHS Healthcare continue to provide this service in Dudley, together with 26 other hospital discharge schemes across the country from Durham in the north-east to Southampton and Portsmouth on the south coast. Our typical key performance indicators for patients who need to choose a care home in order to move out of hospital are: 100 per cent contacted on the same day, home chosen within 48 hours of referral and transfer to care home within five days of referral.

We also run major discharge to assess services including in Gloucester, where we run the whole scheme, directly employing nurses and social workers and in Birmingham in a large scale, city-wide scheme.

Dr Richard Newland, chief executive of CHS Healthcare, founded the company 20 years ago while working as a GP and recognising the gap between hospital and community based care.

“We are delighted to receive this endorsement in Lord Carter’s report. It is an extremely impressive, insightful and forward thinking report which sets out very clearly how greater efficiency can be achieved in the NHS.

“We welcome the focus on the hospital discharge process and the key message that although discharge can be complex, hospitals can and should take greater control: it is not out of their hands. We can achieve enormous reductions in delayed discharges with our flexible, 24/7 work with patients and families and co-ordination between acute and community care.”

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