New approach to hospital discharge helps 500 patients recover at home

A bold new initiative at Swindon’s Great Western Hospital has helped more than 500 people who no longer require care on a ward to safely continue their recovery at home.
Three women with balloons in the shape of the number 500

HomeFirst, which had an initial launch last summer, aims to get patients quickly back on their feet by putting appropriate support measures in place to ensure longer-term care needs can be assessed away from a hospital setting.  

More than 500 people have so far benefited from HomeFirst, and it is hoped this number will continue to grow now that the initiative has become fully embedded across the hospital.  

Supporting people who are no longer in need of ward-based care to return home not only aids individual recovery, but also helps in freeing up beds for those most in need.  

Gordon Muvuti, Director of Place for Swindon, Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board, said:

“HomeFirst is a fantastic example of three organisations – Great Western Hospitals NHS Fountain Trust, Swindon Borough Council and the integrated care board – working in unison. 

“Where a patient’s journey home from hospital could once have been affected by cross-organisational obstacles, we now have a system in which the key players are supporting one another, often from the same room, to overcome any such barriers. 

“Even during these first few months, this improved way of working together has really shown its worth, with patients telling us they are happier at home, and staff pleased to have more beds for those who really need to be there.”  

Only patients classed as medically fit to return home can be considered for HomeFirst, with teams at the Great Western Hospital carrying out daily ward rounds to ensure all eligible people can be identified as quickly as possible.   

Once a person has been selected for HomeFirst, their current needs are assessed, and any longer-term support needed at home is put in place. 

During the first three months of 2023, 53 per cent of HomeFirst patients were able to leave hospital on the same day as they were told they no longer needed inpatient care.  

Further to this, in March alone, the initiative saved the Great Western Hospital more than 350 bed days, meaning more ward space was available to those needing round-the-clock care.  

Sarah Knight, Head of Clinical Operations, Great Western Hospitals NHS Foundation Trust, said:

“Home is the best place for continued recovery, and HomeFirst means that when a suitable patient is ready to leave hospital, they are assessed in their own home within 72 hours of being discharged.

“During this time, therapists, nurses, volunteers and social care workers join together to plan for ongoing care at home, and this can involve providing equipment, such as adapted toilet seats and handrails, and carrying out wellbeing checks.

“Discharging more people as soon as they are well enough to leave hospital reduces any further risk of deconditioning, and also helps to restore independence sooner.” 

Patients are informed about HomeFirst as soon as they are admitted to a ward, with their families also provided with information on how to support the discharge process.

Small steps, such as being available for lifts, collecting groceries and prescriptions, and making sure the patient’s home is ready for their return, can all help to speed up the journey out of hospital.

Further information about the Great Western Hospital, as well as details of other local health and care services in the region, can be found online at www.bsw.icb.nhs.uk.

The photo above shows Rachel Palfreeman, Matron for Clinical Operations and Patient Flow, Great Western Hospitals NHS Foundation Trust; Sally Smith, Integrated Patient Flow Lead, Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board; and Ali Freeman, Service Manager for Intermediate Care, Swindon Borough Council.