News

Keeping the community moving is key to patient flow 

Uko Umotong

National Discharge and Community Services Manager

On March 31 the existing schemes which have funded care for people discharged from hospital will come to an end. These schemes have covered costs for up to six weeks care in the community while patients receive rehabilitation and assessments, and long-term care is arranged. This funding had a direct impact on patient flow by removing a lot of the issues traditionally associated with delays including choice and decisions on funding. 

While patients have moved quickly out of hospital into community beds the move from temporary community beds to long term care has not been as quick in all circumstances.  There are patients who received funding in the initial phases of the pandemic who have not yet been moved into long term arrangements.   

This week marks the one-year anniversary of Boris Johnson announcing the national lockdown and the last 12 months have been a huge challenge for all organisations involved in health and care. While it’s important to acknowledge the huge efforts as well as the toll of the pandemic there is no doubt that difficult times lie ahead as well. It’s predicted elective surgery waiting lists could balloon to around 8 million people by the autumn

Patient flow lies at the centre of reducing these waiting lists. Last week the government committed to £594m funding from April to September 2021 to enable patients to leave hospital as quickly and as safely as possible, with the right community or at-home support. 

While it is unclear at this stage how different areas will deploy this funding. What is really important, to ensure this funding has the biggest impact, is that as patients leave hospital dedicated support is available moving them through rehabilitation and assessments so that they are able to settle into long terms care as quickly as possible. 

Schemes 1 + 2 have been a success on the whole but too often six weeks funding has been seen as a given and this slows down patient flow and reduces capacity in the community. With the right focussed support moving assessments forward, making arrangements for long term care and supporting families in decision making we can maintain flow as well as make sure people have the right care in the right place at the right time. 

How data can support efficient discharge management 

Uko Umotong, Hospital Discharge & Community Services Manager

We know that efficient discharge and patient flow are especially critical at the moment given the ongoing pressures on the NHS and social care and with a “new normal” potentially on the horizon. 

To open the discussion around how this can best be managed, we recently held the fifth session in our ongoing webinar series, “How can data support better discharge management?” Here we heard from Lisa Duncan, Urgent Care and Senior Operations Manager at Staffordshire and Stoke-on-Trent CCGs, as well as Kate Tatton, Business Manager (Midlands) at CHS Healthcare. 

We discussed the ongoing challenges in discharge management, and how data can be used to overcome them. With the example of CHS’s dashboard, we were able to highlight how an integrated management system can play an important role in this process, as well as planning for the future. 

 

Overcoming challenges in discharge management

Some of the main challenges in discharge management include:

  • Understanding real-time demand for services and patient status
  • Having to consult multiple reporting systems for information and lack of interoperability between them
  • Managing flow through Covid-designated spaces

There must be an understanding of where patients are in the system, how they are moving through it, and how this fluctuates. The best way of achieving this is through access to real-time, system-wide data. We heard from attendees that nationally, people across systems and job roles find it challenging to access the information they need when they need it. Accounting for additional Covid-19 requirements like designated spaces is incredibly difficult without this. 

Where this data is available, it allows users to look at specific areas requiring attention, as well as being able to step back and look at the system more holistically to understand the impacts that activities in specific areas have on one another.

 

Informing diverse stakeholders

The Covid-19 pandemic has undoubtedly furthered partnership working. Given the volume of patients moving through health and social care systems and the necessary pace, there is a need for a collective way to manage the data that are critical to the oversight of this process. 

Discharge processes often occur in silos, despite there being several stakeholders across health and social care involved in the patient journey. Different stakeholders will need different types of information, so we need a system that caters for this. This could include:

  • Bed occupancy in acute settings and in the community, as well as insight on where fluctuations may be coming
  • Where patients are at a given time, how long they have been there, where they have come from and where they are going
  • Infection control in the community (such as outbreaks in care homes) and how this will impact the wider D2A system 
  • Opportunities to involve other partners like mental health services 

 

CHS’s Discharge Pathway Analytics

CHS has developed a web-based dashboard that houses all of the above information, accessible in real time. The dashboard is access-led so all stakeholders only access what they need and is relevant to them. 

 

Using data and insights to plan for the future

From this information we can draw insight, which is incredibly valuable for ongoing decision making as well as evidence-informed future planning. The partnership working facilitated through a system like CHS’s dashboard allows stakeholders to move past the step of needing to collect and collate information to instead focus on what comes next given what they already know. The consequences of this are far-reaching, especially in planning and commissioning.

With the transition to Integrated Care Systems, this level of connectivity will be crucial, allowing a system to understand where gaps lie, where investment needs to be made, and how efficiencies can be enabled. At the local level this also means services can be strengthened to meet needs that will vary across and between populations and fluctuate over time. This oversight will also be key to admission avoidance and understanding if existing pathways are correct for different patients. 

 

During the session we received questions on the follow topics, both in relation to CHS’s Discharge Pathway Analytics and data supporting discharge management.

How do we balance sharing data appropriately but openly, and ensuring the right people have access to the right information? What reporting is available?

Data sharing is an ongoing issue, especially given the number of different organisations and sectors involved in hospital discharge. CHS’s dashboard provides an example of where having data housed and updated in a centralised database allows for real-time information to be extracted from the highest to the most granular level. As it is access-based, there are assurances that everyone who needs oversight has this and sees only the information that is required for their decision-making processes. 

In order to offer valuable insight, platforms need to have a reporting function that allows a user to look at discrete snapshots as well as trends, and to allow people to build their own reports based on their needs. CHS’s system shows real-time data and updates every 15 minutes. It can also be set to give you a snapshot report at a specific time, in line with any internal reporting requirements.

How can a data management system be used to account for requirements due to Covid-19, such as testing status and management of designated settings? 

Because a system like CHS’s dashboard houses its data in a central database, it can store data specific to Covid-19 such as testing status. This can be accessed on both an ad hoc and a real-time basis. Covid-designated settings are an example of where clear oversight of bed occupancy and length of stay are especially important. 

We have 3 local authorities, 1 community nursing partner, 2 acute hospitals, 3 community hospitals, 13 PCNs – would it be possible to use this tool across this entire footprint?

A system like CHS’s would be beneficial to disseminate information through this system and allow for proactive planning. 

How can we ensure as trusts that we are working in the same process?

Data held within the database will support process planning and performance metrics will allow trusts to measure consistency and alignment. Data integrity is key here – data entry is accurate and reliable ensuring output can be trusted.

A recording of the webinar is available here. 

CHS Healthcare acquisition announcement

CHS Healthcare and Acacium Group are pleased to announce that Acacium Group has completed the acquisition of CHS Healthcare. The support of Acacium Group will provide a catalyst for delivering innovative patient flow and pathway solutions across acute and community settings. Acacium Group and CHS Healthcare provide different but complementary services, and this acquisition will enable patient needs to be better served. There will be no changes to our customers’ current service delivery or our contractual terms, and we will continue supporting all our customers to the high standards we have always delivered. Dr. Gabrielle Silver, CEO, says, “CHS Healthcare is excited about joining Acacium Group. Our expert team has strong relationships across health and social care. They make a difference to the wellbeing and outcomes for patients and their families every day. The support of a healthcare solutions partner working with CHS Healthcare will provide a catalyst for delivering innovative patient flow and pathway solutions across acute and community settings. Together Acacium Group and CHS Healthcare can meet the changing needs of customers and the health and social care sectors.”

For more information, contact Ben.Hackwell@chshealthcare.co.uk.

Continuing Healthcare: Getting it right first time Key takeaways from the Parliamentary and Health Service Ombudsman’s report

The Parliamentary and Health Service Ombudsman (PHSO) released its report, Continuing Healthcare: Getting it right first time, in November 2020. The report is the culmination of the PHSO’s review of complaints concerning NHS Continuing Healthcare (CHC) between April 2018 and July 2020. 

CHC cases are reviewed by the PHSO when they are not otherwise resolved by NHSE. The PHSO’s findings are shared publicly, with the goal of holding organisations to account and offering opportunities to learn from past mistakes. In this report, failings were identified on the part of CCGs both in the planning of care and support as well as in reviews of previously unassessed periods of care. On the former, failings in care and support planning paired with poor communication resulted in families bearing additional costs for care. On the latter, failings in reviewing previously unassessed periods of care resulted in families facing long periods of uncertainty about finances, as well as financial and reputational risk for CCGs. Getting these reviews right and ensuring past mistakes are not repeated is critical.

Having identified these failings, the PHSO made a series of recommendations, including:

  • Supporting the skills of NHS CHC practitioners, to ensure that staff have the skills and experience necessary to undertake CHC assessments
  • Sharing learning nationally, through a review of the current CHC learning opportunities and tools, and delivering additional educational opportunities for the workforce
  • Supporting people and providers through the NHS CHC process, by ensuring that everyone involved is aware of funding arrangements and additional service requirements
  • Developing national guidance for reviewing previously unassessed periods of care to clarify CCG’s obligations
  • Ensuring that CCGs have the capacity to meet these obligations

The report and its findings arrive during an incredibly complex time for the NHS and CHC alike. As a result of COVID-19, the Government announced a pause on CHC reviews and assessments between March and August 2020 and implemented interim funding for hospital discharge and care placements. Throughout the pandemic, organisations across the country have been adopting various approaches but in the midst of another lockdown and ongoing pressures on the system, ensuring that review and assessment processes are being undertaken efficiently and effectively is critical – both for current cases as well as those previously deferred. 

The key to achieving this will lie in effectively implementing the PHSO’s recommended measures; ultimately it is about ensuring the specialist skills and the capacity to manage this process are in place and clear communication is maintained throughout. CHS Healthcare is uniquely placed to support this process, having provided clinical support, advice, and consultancy in CHC to over 100 CCGs, and holding the largest CHC footprint in England, with services across all 7 regions.

You can read the PHSO’s report here

Managing safe discharge and Covid-designated spaces this winter

Uko Umotong, Hospital Discharge & Community Services Manager

Government guidelines request that NHS and local authorities ensure a 14-day isolation period for patients discharged from hospital into the community. As has been reported recently there are a limited number of beds designated for this purpose, which is why it is important that existing capacity is managed closely to deliver consistent and efficient patient flow. At the same time, we must provide a safe and reassuring experience for patients and their families.

We recently held our fourth session in our ongoing webinar series, “Managing safe discharge and Covid-designated spaces this winter”. Joining the webinar were guests from across NHS trusts, CCGs and local authorities. We were pleased to be joined by Natalie-Jane Macdonald, CEO, Sunrise Senior Living and Tina Snowdon, Area Manager CHS Healthcare to discuss the importance of efficient tracking and management of Covid-designated spaces under the new government guidelines this winter.

 

The challenge of designated settings

Speaking from her first-hand experience of seeing how Covid-designated settings were being handled and implemented, Tina noted that the process has been hindered where a “one size fits all” approach was taken, and that contextual insight is critical for each setting. 

As Covid-designated spaces are allocated, the primary blockers to efficient patient flow and correct implementation include the number of beds and space of the care provider, test results not coming back in a timely fashion, as well as simple lack of clarity regarding the next steps. People are often unsure of what is happening next and lack the necessary information required in determining whether a patient is ready to move on and where they need to be going.

Furthermore, as Natalie noted, designated settings are a good idea but for certain patients, such as someone with cognitive impairment, going to hospital in the first place is a hugely traumatic experience. To then move somewhere else – where they have likely never been – to be looked after and then to move again can cause significant deterioration in their level of functioning. “Our Sunrise or Gracewell home is our residents’ home. We have to be able to welcome them back from hospital whatever their status is,” she said. 

 

Tracking and oversight are critical for safe discharge

At the time of the webinar, the latest CQC data on Covid-designated settings and the South East showed that 1,500 beds had been provided by local authorities for use as designated beds, but only 141 of them were approved for use by the CQC. With a limited number of beds, we need to be able to know who is where at any given time and what their care needs are.

We are currently working well with the D2A model and designated discharge settings. “If we know where a patient is going before they leave hospital and we know that they are there for two weeks, then we can be planning while they’re in hospital, before they go to their designated discharge setting, and identify where they need to be going onwards from there. The flow has already been mapped before they leave hospital,” noted Tina. There have also been successes in using available hospital wards for the 2-week isolation period to avoid the use of an additional separate setting, though this is again subject to bed availability. 

Discharge planning should start at admission and this imperative doesn’t change because of Covid-19. “It is critical that we are using beds efficiently, ensuring tight tracking, making sure plans are in place and that everyone involved is aware of what is going on, including a patient’s family. When we pull these facets together, we can really have a slick and swift operation while ensuring as minimal impact to the patient as possible, as the patient is at the forefront of all our minds,” noted Tina.

 

Looking ahead

When asked about the current state of play, both Natalie and Tina agreed that it is essential to recognise that everyone is experiencing the same level of uncertainty, noting that each person and every organisation has a role to play in supporting care at this time. While it is critical to reduce and prevent infection, organisations must be focussed also on doing their utmost to maintain quality of life for patients and their families, for the limited time they may have together.

Looking ahead, the best way forward is to ensure clear and efficient communication amongst all partners, recognising that together we are able to cope with the challenges posed by the pandemic. Placing patients’ needs at the forefront of decision-making and efficiently implementing detailed planning and tight tracking of a patient’s journey through the system is the basis of effective patient flow.

As Tina concluded, “This year we have seen the ability for people to adapt and to pull together and work together and implement things that they never believed they could do”. This is the energy we need to continue with in the year ahead.

CHS Healthcare has been supporting CCGs with hospital discharge pathways nationally for 25 years  and are well-placed to support CCGs and local authorities to tackle their current and ongoing priorities. For more information, contact enquiries@chshealthcare.co.uk to discuss your needs.

You can access a recording of the webinar here: https://chshealthcare.co.uk/events/webinar-managing-safe-discharge-and-covid-designated-spaces-this-winter/   

Staffing and community capacity – what’s the real issue?

Dr Gabrielle Silver
CEO CHS Healthcare

Hospital discharge and capacity in the community is becoming an increasingly important issue, with the pressure to keep patient flow moving out of hospital and into the community. Today (7 Jan) on Radio 4 we heard from Chris Hopson, CEO of NHS Providers: ‘Hospitals beds are full, community beds are full and community at home services are also full’. The HSJ also reported on Tuesday (5 Jan):

A spring-style policy intervention to require discharges to be arranged in hours, rather than days, with no dithering over cost, may be required. But where will the staff come from to achieve this? And where can individuals go if they are not ready for home? How do we ensure care homes are not compromised with COVID, and how to enact new policies with the independent care sector setting its own rules?

This highlights how the challenge of staffing has been drawn into sharp focus through this pandemic. I believe we need to think more laterally about how we support aspects of health and care. Hospital discharge is, at its heart, a practical process. Once a patient is medically optimised to leave hospital the clinical job to a large extent ceases. This is why I am not convinced that the issue is staffing per se. I think the issue is how hospital discharge is resourced day-to-day and a lack of effective management tools in the NHS.

Managing the discharge to assess (D2A) pathway is about having strong relationships with local care providers, working closely with families to make sure they are reassured and confident about next steps for their loved one and actively managing each individual’s care timetable to move rehabilitation along.

I see our team’s job as ‘keeping plates spinning’. On a practical level, this is making sure appointments such as occupational therapy take place on time and that any follow-up, like ordering equipment is managed. This detailed hand holding of each patient’s needs means that their care actively continues, and they are able to move quickly back home with support, or into a long-term bed with appropriate funding. And their original bed back goes into circulation for another patient who needs it.

A key element of this is the real-time tracking of patients and their care. We use a digital platform to ensure information about next steps are visible and available at any time to the team involved in their care. These tracking systems are increasingly important within acute trusts to monitor flow across multiple data feeds. We use the same logic but apply it to the discharge and rehabilitation of patients. Gone are the days when care is held up because an excel spreadsheet was not updated or someone forgot to pass a message on or record an appointment.

Technology, deployed correctly, guides staff so they are doing the exact right tasks at the right time to ensure an outcome – in this case patient flow.

As unpredictable as this pandemic has been, we know that pressure on hospital beds will continue for some time to come and that people will need to move promptly from acute services and will require substantial care in the community. The NHS has a huge amount of work to do and where we can provide support and keep things moving, we want to do so.

The workforce solution for many of the current challenges does exist. We must think beyond the NHS for solutions to non-clinical challenges. Where we look to the NHS as the only viable option, we do patients and even people waiting for vaccines a disservice. We need to be proactive and pragmatic – let the NHS get on with the complex and urgent work they need to do and are best placed to do.

When I look ahead past this pandemic and the long-term workforce challenge, I can see that there will be jobs created around health and care which have not even been considered yet. Jobs which we have seen as ‘clinical’ will be broken down and rebuilt as operational support in a whole range of new guises. This will benefit hugely not just the NHS but a completely altered labour market. Data and technology will play a huge role shaping these new job roles. In the meantime lets wrap our support around the NHS at this testing time – we all have a role to play.

Recognition from our partners at Maidstone and Tunbridge Wells NHS Trust

We are thrilled to have received special recognition from Maidstone and Tunbridge Wells NHS Trust (MTW) for our ‘exceptional service during the COVID-19 pandemic’.

At CHS Healthcare, we understand the importance of delivering seamless and efficient patient flow in helping our clients maintain a standard of excellent patient care. Whether it’s working to get a patient back home with family, into rehabilitation or a care home, our aim is to ensure patients get the care they need in the best and most appropriate location.

“The team became part of our team” states Stephanie Line, the Discharge Liaison Team Leader at Maidstone Hospital. “We worked as part of a team, alongside each other for the positive outcome of our patients and their family.”

“The current pandemic has been the hardest times we have worked through and one which we are still powering through. I speak on behalf of myself and all colleagues, we could not have survived without the [CHS] team’s support. Their commitment and support to us has been exceptional, they have assisted us to stay afloat.”

“It’s a real honour to be recognised by the MTW team in this way, as we’ve done our best to deliver a high level of enthusiasm and commitment to perfectly align with their operations”, says Debbie Haddow, Team Coordinator at CHS. “Whether it is bringing our extensive industry knowledge to the table, reaching out to homes or agencies to better understand admission policies, or helping to enhance their relationships with hospital discharge teams to increase exposure, we are extremely proud of the work we’ve been doing and are thrilled to be acknowledged like this during such a difficult time.”

Hospital discharge – what really counts for patients and families? 

New guidance in March significantly changed how hospital discharge takes place. But how are those changes going? Not well, according to HealthWatch England and the Red Cross in their new report What happens when people leave hospital and other care settings? which reflected on 590 people’s experiences of hospital discharge at the start of the pandemic when this new guidance was being implemented. 

They found:

  • 82% of respondents did not receive a follow-up visit and assessment at home, one of the key recommendations of the policy. Almost one in five (18%) of those also reported having unmet needs, such as equipment, medication or advice
  • Some people felt their discharge was rushed, with around one in five (19%) feeling unprepared to leave hospital
  • Over a third (35%) of respondents and their carers did not get a contact for further advice, despite this being a recommendation
  • Overall patients and families were very positive about healthcare staff, praising their efforts during such a difficult time.

I was interested to read these findings as earlier this year just before COVID-19 became part of our day-to-day we undertook a survey via the Patients Association of friends and family of people who has recently been discharged. We wanted to understand their experience of finding care and what support was useful.   

When we asked families for their experiences the guidance was focussed on reducing the numbers of ‘super stranded’ patients. Trusts were asked to do a number of things to help older people be ready to leave hospital as soon as they were medically fit. The majority of friends and family we surveyed (72%) were not informed of the risks for older people of staying in hospital when they were ready to leave and 60% of people said that their loved one was not encouraged to stay mobile or active while in hospital. 

We asked families if they had enough support to make decisions about future care and 71% of respondents said there wasn’t enough information. 

Now hospital discharge is a very different process – the high numbers of super stranded patients we used to see are a thing of the past – which is a very good thing. But it was sad to see this report finding the new processes left people “feeling unsafe” when sent home.  With one in five patients feeling “unprepared to leave hospital” which increased to 27 per cent among those who were discharged at night.

COVID or no COVID, we still haven’t got hospital discharge right for patients and their families.

We know from our survey people want more advice and support – either from doctors and nurses (65%) or a dedicated resource who knows the local care options (62%). They also want a better understanding of funding options including social care and benefits (60%). 

Family liaison is key to unlocking the support of families so they can make decisions confidently and quickly, so they feel assured about the next steps for their loved ones, so they know when they can visit them at their care home. In addition, to make new discharge pathways work effectively we need to have the right dedicated support for health and social care teams. This includes coordination of assessments and therapy as well as for meds and equipment, support of commissioned and spot purchased beds as well as overall visibility of the patients care journey.  This all sounds simple but without the right focus a lack of coordination can quickly overwhelm and block patient flow. 

It’s likely this is going to be a dreadful winter.  We can make things easier on patients and families as well as health and care teams by acknowledging simple fixes and release health and care teams to focus on complexity where their unique skills are needed. 

Winter discharge planning and developing your D2A pathways

Dr Gabrielle Silver, CEO

Facing both a second wave of Covid-19 infections as well as the winter period, we know it’s critical that discharge pathways are in place to ensure patient flow and safety. 

We recently held a webinar entitled, “Winter discharge planning and developing your D2A pathways”. The purpose was to gain insight into how people are managing the Government’s Hospital Discharge Service guidance issued at the end of August, which gave clear direction on the purpose of D2A pathways to ensure ongoing and efficient patient flow. 

We had almost 200 professionals from hospitals, CCGs and local authorities join this third session in our ongoing webinar series. Dawn Hallam, Discharge Manager, Maidstone and Tunbridge Wells NHS Trust and Kent Community Health NHS Foundation Trust and David Coyle, Chief Operating Officer, The Countess of Chester Hospital NHS Foundation Trust shared their insights on establishing optimal community pathways. 

Optimising the D2A model 

Ahead of the session we polled registrants to understand whether they felt confident that their D2A pathways would be able to discharge patients within the 6-week funding limit. Interestingly, the results were split, and we wanted to gain insight on what is working well, and the challenges people are facing.

To optimise the D2A model, it is vital to continually think about whether someone is medically fit for discharge, and how an intermediate care bed base can continue to support the care of those patients outside of an acute hospital setting. 

Both David and Dawn agreed that it is important to ask questions daily about why patients can or cannot go home on that day, as well as ensuring close collaboration across all systems, including local authority and community partners. Both also noted that it is important to make sure expectations are managed, which means having a solid and functionally aligned operating team. 

Additionally, among care providers there is a nervousness to accept patients who have had a previous positive Covid-19 swab, which is another reason why transparent communication with care providers is hugely important.

The main D2A challenges

We also asked registrants about their main D2A challenges, with the highest response being coordination across health and social care to enable effective flow, followed by getting assessments to take place at the right time. 

Both Dawn and David noted that when the first wave of Covid-19 hit, there was a rush to clear hospital beds. Patients were quickly moved into the community and there was a decrease in both hospital occupancy and referrals. At present, the number of patients is increasing, and there will have also been a significant number of incomplete assessments over the past several months. Given the discharge of high volumes of patients directly to care homes and the time-limited financial support that currently exists for those patients, there must be close collaboration between hospitals, local authority partners and allied healthcare professionals to ensure assessments are completed as efficiently as possible. 

Additionally, as social service team members were instructed to leave hospital at the onset of the pandemic, teams have had to adjust to online working and different methods of communication than would have previously been the norm.

David noted that: ‘’From a D2A perspective, working closely with local authority and community partners is important – there is a higher level of dependency in the community now because people who didn’t come in during the first wave of Covid-19 have deteriorated. There are more pressures now, as we are dealing with a sicker, more frail population. Importantly, we do not have the same access to the care provider landscape because of the need to ensure we are maintaining infection control, which adds further complexity.’’

Dawn noted that: ‘’In the first wave of Covid-19, too many patients were sent out to a bedded solution, when they could have been sent home. The focus is now to firstly ask why a patient cannot go home. Sending patients home should be the first option, because it is the best place for the patient. That will be the shift in how we will deal with the second wave – making sure we have as many people at home as possible.’’ 

Support for D2A and winter planning

We also asked registrants about the support they need most around D2A and winter planning, with the highest response being support with managing capacity. Other responses included the resource to deliver local plans, support with onward care arrangements and restart of CHC assessments.

Coordinators, occupational therapists and physical therapists are vital for facilitating rehabilitation in the community. ‘’A challenge has been getting acute therapists working in the community and not in the hospital setting. Many assessments happenin hospital rather than the community, and this is something we are trying to change’’ said Dawn. 

Hopes for the future

Looking ahead, it will be important to align on a single version of what ‘good’ looks like to manage expectations throughout the discharge process. It is important to keep flow moving and keep patients safe and out of hospital. Sharing information, and indeed ensuring everyone has the same information is essential for this. 

Regarding treasury funding, Dawn noted: ‘’It is important to remember it is up to 6-weeks, therefore you should be aiming to [complete assessments and confirm placements] in less than 6-weeks. The 6-week timescale means there is more of a focus for speed.’’ 

Having visibility over what is happening in different cohorts and prioritising work is important. Additionally, tracking across different pathways is vital for managing expectations. 

Both Dawn and David concluded by stating that for community pathways to become better established, more communication and joint responsibility is needed to make sure patients are in the right place at the right time. If there is clear communication, and everybody knows what they are expected to do, we can provide a better overall discharge experience for patients.

CHS Healthcare has been supporting CCGs with hospital discharge pathways nationally since 2013 and are well-placed to support CCGs and local authorities to tackle their current and ongoing priorities. For more information, contact enquiries@chshealthcare.co.uk to discuss your needs.

You can access a recording of the webinar here: https://chshealthcare.co.uk/chs-webinar-winter-discharge-planning-and-developing-your-d2a-pathways/ 

CEO Dr Gabrielle Silver named in LDC’s Top 50 Most Ambitious Business Leaders for 2020

Our CEO Dr Gabrielle Silver is one of only two healthcare services leaders in the UK’s Top 50 Most Ambitious Business Leaders


We’re pleased to announce that our CEO Dr Gabrielle Silver has been named as one of thirteen women and one of two healthcare services professionals in LDC’s Top 50 Most Ambitious Business Leaders for 2020. Now in its third year and featuring more than 350 individual nominations from across a spectrum of industries, the programme celebrates the inspiring leaders behind some of the UK’s most successful and fast-growing medium-sized firms. 

A doctor by background Gabrielle left clinical practice to work for in the pharmaceutical sector. Since then, she has worked at a series of organisations, all of which help to improve quality of life and outcomes for patients. 

‘The last business I ran was integrated into a large organisation, and I knew I wanted to be part of a smaller company again. I like the small business environment, pulling together a strong team and taking absolute responsibility for outcomes. When I joined CHS, I wanted to wrap my arms around the organisation. I just knew I could help the business evolve’. 

Since joining CHS Healthcare as chief executive in January 2019, Gabrielle has worked to grow and develop CHS Healthcare into the leading provider of hospital discharge services and Continuing Healthcare. 

‘What’s unique about CHS is that we are an independent arbiter: we explain all the options to families and patients and know about each care provider. The reality is nurses aren’t trained to help families choose care providers – that isn’t their job. We get people the right care by working in partnership with the NHS, local authorities, care providers as well as patients and their families. 

2020 and Covid-19 has bought unexpected challenges for the health sector and consequently for CHS. 

“I don’t think any of us could have predicted this pandemic let alone it’s impact on health and care but the way the CHS team has adapted to the challenges over the last months has been beyond impressive. We moved our teams out of hospitals, where we worked alongside discharge teams, and developed a remote methodology for assessments and enabled by our software products. This meant we could effectively support our colleagues and importantly, many patients and families over the initial Covid-19 phase. As we move into winter, new discharge pathways are being developed utilising community-based care in a more effective way. We are developing these intermediate care settings, building stronger relationships across providers and the NHS, as well as continuing to provide dedicated support for patients and their families.

We know winter 2020 is going to be like no other.  I am proud to be leading CHS Healthcare and the amazing team who really do make a difference to wellbeing and outcomes for patients every day.’

To learn more about this year’s Top 50 Most Ambitious Business Leaders programme, visit: https://bit.ly/2HE8SL7 

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