Britain is a country with a Health Authority called Medway where old men no longer lanquish longer than necessary in hospital

With winter looming and health and care teams in Britain faced with the usual prospect of old men and women being left stranded on hospital wards because of the lack of provision when they are discharged, there is one area where their prospect is much brighter : the Medway Towns in North Kent. Here, the Medway Foundation NHS Trust has shown what can be achieved with the right mindset.

Working in partnership with 'Medway Clinical Commissioning Group', 'Medway Council' and 'Medway Community Healthcare,' the Trust has developed the 'Home First Initiative.' It provides support for patients who still require additional home support but, at the same time are medically fit to be discharged from hospital.

Since its introduction, 2,000 patients have been discharged under the seven-days-a-week scheme, which has four patient pathways, ranging from those needing little or no support, through to those with complex needs who may need intermediate care and may not be able to go home safely immediately. With this level of support in place, Medway has found that permanent admissions to care homes for the men and women 65 have halved since the introduction of the scheme which was implemented in April last year just a few weeks before a visit by inspectors from the Care Quality Commission. It used existing teams but removed historical 'territories' and created a single point of access for all coordination of a patient’s discharge. Under the new system patients have :

* transport arranged to their homes
* an assessment at home by an occupational therapist within two hours of leaving hospital
* a personal care plan for their therapy, goals, carer provision and any equipment they require
* if necessary, a care package which may involve 'telecare' and 'wraparound care', with people ringing to make sure medication is taken

Project lead Lisa Sladden of Medway Community Healthcare said :

"We know that most people would rather recover at home than in hospital and getting back to our lives and our routines is an essential part of that recovery. It helps us to regain independence, and allows us to receive care in a comfortable and familiar environment. 'Home First' aims to help patients do just that by working with community partners across Medway."

This is not the end of the story. Last year, before the Scheme was implemented, the number of days that patients, composing largely of elderly men and women, languished in hospital longer than was necessary was running at 774 days per month. That figure, after the implementation of the Scheme, has dropped to 475 days per month. Naturally, in an ideal world the figure would be zero, but Medway's 'Home First Initiative' has put its hospital patients way out in front in terms of speedy and supportive discharge from hospital in comparison with other parts of the country, where their counterparts continue to languish far too long in hospital beds.