6 In and out of hospital No more missed opportunities: our recommendations We know that many hospitals are under serious Avoiding unnecessary pressure this winter and that, for many areas, hospital admission these pressures will continue all year round. The need for more resources, not least for adult > Invest in non-clinical personnel in social care and interventions to prevent people A&Es to help prevent people who are reaching a crisis point, underpins most of the medically OK but need support at home issues explored above. from being admitted. Non-clinical personnel have the time to Nonetheless, there are a number of practical, provide the flexible, person-centred support simple solutions that could make a big others in busy accident and emergency 4 difference both to people and ‘patient flow’, departments often do not have time for. at minimal cost to the health service. Importantly, they are able to take people The research we have conducted, including home safely who might need a little bit of insights from our own front line staff and service support but do not need to be in hospital. users, has informed our recommendations. > Ensure there are more multidisciplinary The key findings are laid out below. teams who work with people at risk of being admitted into hospital. These Helping people feel safe at home teams should be located in the same offices, > Automatic home assessments should have regular meetings and shared access be triggered for people who have come to care records. Voluntary and community in and out of hospital several times sector representatives should be fully within a few months. We encounter involved in these teams. people who have come in and out of Helping people home hospital with nobody questioning why their needs have spiralled into something much from hospital more complex. While people might appear > All discharge ‘checklists’ must include to be medically fit enough for discharge, a an assessment of equipment and regular cycle of readmission often signals medication needs, from wheelchairs that something is amiss at home. to blister packs. These should be arranged > The Government should seed-fund before leaving hospital. proactive falls prevention schemes, > At a minimum, transport home from ensuring people can access the simple hospital should be offered to all those home adaptations and mobility aids they who live alone, who are leaving need to live independently at home. hospital alone and have poor mobility. > People who live alone, have poor Anybody transported home should be mobility and have been in and assisted inside. Assisting patients inside out of hospital due to falls should their home provides an opportunity to check automatically have their home their home environment. assessed for falls hazards before they are discharged. 4 The movement of patients along a pathway of care, including in, through and out of hospitals.