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Oxford University Hospitals NHS Foundation Trust

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Integrated Care in Action Week - our first blog

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Getting home from hospital more quickly in winter

Being in hospital for longer than needed can often worsen a patient’s general condition, and even increase their long-term care needs.  Not only that, but nobody wants to stay in hospital longer than necessary, and being treated in your own environment surrounded by your own comforts can play a big part in aiding recovery. 

With that in mind, one of our teams at Oxford University Hospitals NHS Foundation Trust (OUH) has been working hard to help patients home quickly and safety this winter with a new 'discharge to assess' (D2A) initiative. 

The HART service is part of a joined-up and collaborative approach to patient care this winter, with health and social care systems in Oxfordshire working together to look after our population this season.  The approach allows us to provide safe, effective, and sustainable care for people across Oxfordshire at a time of increased demand on both health and social care services.

Commissioned by Oxfordshire County Council, HART is run by OUH and neighbouring Oxford Health NHS Foundation Trust.

The HART service and what the team does

The Home Assessment Reablement Team (HART), a multidisciplinary team who provide support and care to patients when they leave hospital, launched the D2A initiative for people who don’t need to stay in hospital, but do need extra support in the short-term to enable them to go home. 

The initiative helps identify these patients earlier, meaning they spend less time in hospital and are then assessed in their familiar home environment to plan for both their short and longer-term needs.

In January this year, the team had supported over 600 patients through the initiative, with 480 of them since discharged from HART’s care – and 50 percent of those people are now living fully independently following their treatment.

One patient who was treated by the team said: "The team really went out on a limb for me – they really could not have been kinder.  They always had a smile on their face and couldn’t do enough for me."

Our Chief Nursing Officer Sam Foster said the initiative was a wonderful development, and that the work the team do is incredibly valuable. 
By changing the location that we make decisions about ongoing care needs to a person’s own home rather than in a hospital ward, we can make sure people are confident and happy in their homes following discharge from hospital.

By helping people regain their independence and continuing our 'home first' approach, the team can continue to deliver care and support in the most appropriate and often happiest setting for our patients.