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Home is the best place for medically fit patients.

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In January 2018, The Guardian published an article exploring the need for the NHS to be supported with a new model of care for preventive healthcare, as opposed to simply a treatment model. Hilton Nursing Partners have demonstrated their abilities to support this and are helping the NHS adopt new models of care such as the Discharge to Assess and Home to Decide service models which get patients home at the earliest opportunity and reduce re-admissions.

Their integrated approach to health and social care has resulted in significantly fewer patients experiencing delayed transfers of care, with the majority of patients continuing to live independently without funded social care support. To date Hilton Nursing Partners have freed in excess of 100,000 hospital bed days and facilitated over 20,000 discharges.

What is so distinctive and innovative about the Hilton model of care?

  • Nurse led service utilising highly trained healthcare assistants.
  • Unparalleled expertise in successful implementing and running discharge to assess programmes.
  • A dedicated service whose staff are focused on getting patients home at the earliest opportunity and supporting them to remain as independent as possible.
  • Reduced pressure on social services as a result of fewer patients requiring funded social care, and a reduction in the average support for those who do require funded social care.
  • A Hilton Trusted Assessor based within the Hospital whose function is to identify patients medically fit for discharge and facilitate their discharge that day.
  • Person centred support to optimize independence for each patient, delivered for up to five days, in accordance with assessed needs.

 

The Hilton Nursing Partners Discharge to Access and Home to Decide models were developed as a direct result of the company’s CEO’s own personal experience of the difficulties within an acute hospital when attempting to link with Social Care and the independent provider sector.

 

“It was clear to me that although everyone in the system has the patient’s best interest at heart, the reality for the patient and their family is often frustration and confusion. Our models of support were born out of such frustration. Although deemed ‘medically fit’ most elderly frail people do not feel emotionally fit after an acute hospital stay and aren’t in the best position to make major decisions such as moving into a care home or even a rehab bed for ‘a few weeks’, says Ann Taylor CEO Hilton Nursing Partners.

 

Explaining the company models further Hilton share Brenda’s story, which demonstrates the support received from the company’s multi-disciplinary team, led by a Nurse, including Healthcare Assistants and an Occupational Therapist.

 

Brenda had been assessed as requiring residential care while in hospital, but both she and her family thought that she would be better placed living at home. The team helped Brenda regain physical and emotional strength. Initially, the Hilton team were with Brenda 24 hours a day, but within three days the team recognised that she was ready to reclaim her independence. Brenda was happy for the night sits to end in the knowledge that support was always just a phone call away. As Brenda’s confidence and mobility improved the team agreed a gradual reduction in calls to two calls per day by day ten.

 

Brenda’s story represents a positive outcome, not only for Brenda herself but also for the acute hospital where she waited for over seven weeks, and for the Social Service team who couldn’t see any alternative, as she became even more anxious daily.

 

And the financial angle – Brenda staying at home saves an estimated £20,800 per annum.

 

Discharge to Assess is for patients who are medically fit and able to return home. Hilton provide a five day period of recovery and assessment with recommendations to the social care and community intermediate care teams.

 

Home to Decide is for patients who have been identified as requiring a care home placement. Hilton provides a 14 day period of assessment and support to the patient and family, through a 72 hour period of continual assessment plus up to 11 days of advocacy and support to select a suitable residential placement. While the first 72 hours will be intensive in all cases, the following 11 days will be either intensive, moderate or recovery support.

 

Rated “Outstanding” by the Care Quality Commission (CQC) Hilton Nursing Partners works with the NHS and Social Care Commissioners to successfully deliver safe, timely and supportive hospital discharges, patient assessments and patient recovery programmes via nurses, therapists and nurse led personal nursing assistants with a proven track record in freeing hospital beds, as well as reducing re-admissions and on-going social services support.

https://www.hiltonnursingpartners.org.uk/

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