TRADITIONALLY, patients admitted to hospital would settle in for a stay of at least a few days, but the latest research suggests that, for older patients in particular, the shorter the time they’re in hospital, the better it is for their mental health and physical recovery.

All the indications are that once patients have been assessed and had any necessary treatment, home is definitely the best place for them to be.

At County Durham and Darlington NHS Foundation Trust, which includes University Hospital of North Durham, Darlington Memorial and Bishop Auckland Hospitals, a new initiative, #NextStepHome, aims to change the way patients and their families think about being admitted to hospital. Launched in November, it’s already showing positive results for patients.

The Northern Echo:

HOME RETURNS: Members of the trust's discharge team Norman Devlin and Dawn Embleton, rear, and Karen Ingram, Judith Henderson and Sarah Sowerby

Consultant physician Dr Paul Peter said: “We know that patients don’t want to be in hospital any longer than necessary. For older people in particular the familiarity of home makes a huge difference to how they feel in themselves. They can eat the food the like, when they want it, follow familiar routines – even enjoy the comfort of a favourite chair.

"Being in hospital can also feel overwhelming – everything is new. So, initially, when a patient comes to us, we ask ourselves whether admission is really necessary – can the patient receive the care they need from our community teams, at home.

"At the moment, the service is specifically for patients suspected of having an acute medical problem or a heart, respiratory, gastroenterology or diabetes issue. GPs are already telling us they’re finding it very helpful and it means patients are getting the care they need, quickly and in the most appropriate place.

“When patients do need to be admitted we make sure they are assessed as soon as possible, including getting blood tests and results, booking scans and any other investigations needed to help us make a diagnosis. From there, we make a plan with the objective of getting any necessary treatment in place quickly, then regularly assessing the patient’s condition so that once they’ve made the improvements we’re looking for, getting them home with packages of care, prescriptions and anything else they need, already in place.

"We talk to patients at every stage, keeping them updated. It requires commitment from everyone to make it work but we have great teams who are focused and work well together.

“One of our main aims it to help patients return to, at the very least, the level of independence they had before their admission to hospital. All the evidence suggests this is more likely the shorter the admission. At home, the activities of normal daily living help keep us active much more effectively than you might imagine. But all that stops when you’re in hospital and muscle strength is lost very quickly.”

Charles Blackford was taken to Darlington Memorial Hospital by his niece, when he became unwell. And the pensioner was delighted that he was able to be treated and return to his home as quickly as possible.

The 82-year-old, from Darlington, said: “I was assessed very quickly and had both a scan and an endoscopy, which revealed I had internal bleeding. I was kept up to date with what was happening and it seems some tablets I’ve been taking have caused the problem. I’m now on a different medication and feel very much better – a district nurse is coming to see me at home tomorrow which is reassuring. I hadn’t realised quite how unwell I was. I came into hospital to get better which is exactly what’s happened – and very quickly. It’s time to go home.”

Sharon Morgan, associate director of nursing for community services, added: “Older, frailer patients, and those with long-term conditions, tell us that they want to stay at home as long as possible and return home as early as possible following an admission. As a healthcare system we’re working in partnership to make this happen. We appreciate that some patients and their families will worry about whether services in the community are robust enough to provide the care and support needed and we want to reassure them we have a menu of services available for them, including community nurses, intermediate care and domiciliary care which supports people to live independently.”

Jon Holmes, consultant in Emergency medicine at the health trust, said: “We don’t want anyone to hesitate to come to the emergency department or ring 999 when it’s an emergency but we also encourage people to consider the alternatives which might be best for the patient – pharmacists can often offer great advice about medication and symptoms, and the 111 service also offers expert guidance.”