"Home First" is a great success
Cooperation between Cornwall Council and the NHS has had a dramatic impact on the number of patients stuck in hospital who are ready for discharge.
The "Home First" programme gives Cornwall Council funding from the NHS budget which is used to employ a multi-skilled team of nurses, occupational therapists and social care workers. This team provides a rapid-response service to ensure that patients can leave hospital as soon as they are ready, supporting them to get back on their feet at home for up to two weeks and then helping them to make better long-term plans.
When home-care packages are arranged whilst the patient is in hospital, there are a number of problems:
- It is hard to assess what the patient will need at home while they are sitting in a hospital bed
- The care needs of patients are often very different in the first few days after leaving hospital than they are a couple of weeks later
- It can take several days for a long-term care package to be arranged
- Frail, elderly patients tend to get weaker with every extra day they spend in hospital
- Hospital beds occupied by patients who don't need to be there are a huge cost to the NHS and result in delays for new patients who need to be admitted.
Home First solves all of these problems.
- The multi-skilled team has the flexibility to offer a full range of nursing and social care support at home
- The team includes an assessor who can help organise the right package of care based on the patient's needs at the end of the fortnight, rather than when they were in hospital
- The scheme provides a two week "breathing space" for a long-term care package to be arranged
- Patients have better outcomes because they go home at the time that's right for them
- Even though the NHS is paying for the Home First workers, it is actually SAVING money because it frees up expensive hospital beds for other patients who need them
This result demonstrates how real improvements to services can be provided simply by allowing money to be moved around the system to where it is most needed. Cornwall Council and the Isles of Scilly Council are now working with NHS Kernow and NHS England to find ways of increasing cooperation so that the whole of Cornwall's £1.2 billion health and social care budget can be used more effectively.