Community Support Programme For Early Discharge

STRiVE

Each month an average of 26 East Lothian patients are medically well but are unable to leave hospital because they required care which could be provided.

However, patients with rehab potential don’t always need high levels of support. By providing community volunteers, partnering with the third sector, and building social capital in the East Lothian supported care pathways, home assessment and rehabilitation work programmes, this project aimed to:

  • reduce unnecessary hospital admissions and readmissions within 28 days
  • increase self-managing of care
  • reduce unmet need for care
  • reduce the number of people delayed in hospital

By focusing on prevention, non-medical and low-level practical support, at points in a person’s life where a short intervention could restore or avoid a loss of independence and confidence, and reduce the risk of a longer stay in hospital or hospital re-admission people were:

  • supported to return home, to their community and retain independence in a way that was safe
  • assisted in lower reliance on care services and to better maintain their own health and well-being

Funding from the ihub was used to cover staff and volunteer marketing, training and research.

  • What was the approach?
  • What was the impact?
  • What was the learning?
  • What are the next steps?

For further information on this project please contact: hcis.improvementfund@nhs.net