Hospital discharge and flow

The key out of hospital cell responsibilities are to ensure appropriate capacity in the system and to support hospital discharge and flow.

The following has been in focus since the last update:-

  • Discharge: the cell has been working with all systems and partners during unprecedented pressure and surge in admissions to maximise safe discharges. Each system has; allocated a senior leader to work across boundaries with all partners to maximise discharges; been actively reviewing patients’ needs with services mobilised accordingly; been adding extra support to local systems where required; been tracking daily performance of discharges vs admissions with real progress being demonstrated. The Cell prepared an updated ‘Safe Discharge and Flow’ protocol, under which place based systems have been sharing capacity and providing mutual aid, as well as helping prioritisation to protect essential services. The focus going forward will be on patients who have longer lengths of stay, i.e. those in hospital for over 14 or 21 days.
  • Capacity and demand modelling:  building on previous modelling exercises during wave 1, the cell has led demand and capacity modelling with support provided by Liverpool CCG BI team. The aim is to create an iterative model for Cheshire and Merseyside system for out of hospital services, that predicts future demand and assesses capacity against discharge needs. This will enable systems to understand interoperability, future capacity gaps and plan services accordingly. Further detail will be shared as this work progresses over the next few weeks.
  • To support work on preventable admissions, the cell has been working with all places and providers to maximise Covid oximetry@home. This service provides an enhanced package of care for individuals with Covid to be supported at home with remote monitoring and appropriate escalation if the patient’s condition deteriorates. Specific communications on this service is under development and will be shared shortly.
  • To support hospital discharge the cell has been working with all places and providers to mobilise COVID Virtual wards. Each acute Trust has now established a Covid virtual ward as an option for patients to be supported for early discharge with improving Covid symptoms.

Further detail will be shared over the coming weeks on these activities and on transition as the cell transfers its functions into either the HCP/ICS and community and mental health provider collaborative.