Supporting earlier , safer discharge in mental health acute care
At the end of 2020 , winter pressures funding was used by Sussex Partnership NHS Foundation Trust to establish occupational therapy-led Home First teams on the acute mental health wards . We find out how the project got off the ground and what ’ s been learned along the way .
H ome First is a nationwide approach to ensuring that no one spends longer than they need in an acute hospital bed . Closely linked to the Discharge to Assess model , it is based on evidence that shows delays in discharge can lead to de-skilling and significant longer-term issues , particularly for older people .
However , this had not been an approach commonly used within acute mental health services , and so winter pressures funding was secured to pilot the approach across three later life wards .
The pilot ran from December 2020 to March 2021 – subsequently extended until May 2021 – and the funding was used to provide additional Band 6 occupational therapy and Band 3 occupational therapy support worker input to each of the later life wards .
This gave the teams capacity for up to four weeks of post-discharge occupational therapy intervention for later life clients and their carers to support earlier and safer discharge .
Supporting patient flow
The Home First occupational therapy staff worked with people in their own homes to re-establish activities of daily living and routines , provide support around equipment and telecare , reestablish community networks , help identify care packages and provide advice and support to carers to enable successful discharge .
Staff worked closely with the multidisciplinary team , community mental health lead practitioner , discharge co-ordinators and other services involved , to ensure a joined-up approach to discharge planning .
Teresa Blunt , Professional Lead Occupational Therapist in East Sussex , explains how the initial gap in services was identified . ‘ We knew that a lot of work had been done around Discharge to Assess in the physical fields – through A & E , or on some of the medical wards in the acute hospital – but there hadn ’ t been a lot of work in mental health settings .
‘ We wanted to see if there was something we could do to have an impact on improving quality for patients and carers , ensuring safe and effective discharges , but also improving patient flow for both economic reasons and freeing up beds .’
She adds : ‘ Initially , we wanted to think about what an occupational therapist ’ s impact on patient
16 OTnews June 2022