“I love my job. I know I’m helping people every day.”

People at CHS Healthcare know that they make a difference – every day. At CHS Healthcare we employ over 280 people as advisors, assessors, administrators, software project managers, regional coordinators, call centre support, and analysts to name just a few roles. One thing we all have in common is a commitment to making sure that patients and their families have all the help they need when making decisions about care while supporting the health and care system to be more efficient.

Many of our people work alongside NHS and local authority colleagues on site liaising day to day with discharge teams, clinical staff and local care homes. Our advisors take families on visits to care homes in the weekend and after hours helping them through the process of choosing a home.

Most often families are navigating the care system for the first time and this can be very stressful. Our help and support can help them feel more confident making decisions about where their mum or dad, aunt or uncle is going to live. Being able to listen and get to grips with what is important for them, do research on their behalf and answer all their questions makes this stressful time more straight-forward and much less scary.

Some of the people we’ve helped have said:

‘’Paula from CHS was like an angel, she actually listened to me and understood what we were going through.

 I don’t know what I would have done without her. It was quite daunting and very stressful, as I knew there was no one else to help Catherine and I wouldn’t have left her.”- Kate Harrison

 “The team were just amazing. They did all of the background work for me, which was great as I didn’t really know what to do, as I’d never had to deal with anything like this before.” – Mary Nicoll

The health and care system is under immense pressure with hospitals at capacity throughout the year. Making sure older people don’t spend time in hospital, when they are fit to leave, means that beds are available for those who need them. This helps maintain the flow through from admission, to treatment, and then to discharge. Supporting discharge teams in hospitals on behalf of the NHS and local authorities requires us to be responsive, knowledgeable and focussed.

What our customers say about us:

“It is difficult to get across just how fabulous the group of people from CHS are. They always go above and beyond.

 “They are in the thick of a very complex situation, which would be immeasurably harder without them.

 “They have a massive task to undertake and great at trouble shooting. It’s hard to say how grateful we are to the team.”

Mel Asbury

 “They are always contactable, very responsive and provide us with regular updates on their progress. This level of communication is essential for us, as it means we have an understanding of what is going on.

 “They are lightning fast at finding care packages and care home placements. This is important as it means people receive the care they need as soon as possible and frees up hospital beds for people who need them.” Colin Shaw

 We’re really proud of the work we do. If you want to find out more about working at CHS, read what Claire, Lucy and Leah say and check out the roles we have available here.

Hospital discharge is not rocket science – why isn’t it working?

We talk with hospitals up and down the country and most hospitals are dealing with lists of over 100 medically fit patients ready to leave hospital. It is upsetting  that elderly people who are ready to leave hospital are stuck there over Christmas while people wait longer for admission. 

What is adding to this picture is our unseasonal December election. Usual winter funding has not appeared across the board and with that, a kind of stasis has emerged across the NHS. The impact is felt in these headlines and sadly by the people seeking help at A&E and the older people who are unable to leave because support for their discharge is not available.   

The bottom line is that once medically fit, staying in hospital is not good for older people.  While they are in there, sick people who need the beds face unreasonable waits, or are sent home or placed into temporary beds in the wrong ward for them across the estate.  

35% of 70-year-old patients experience functional decline during hospital admission in comparison with their pre-illness baseline; for people over 90 this increases to 65%. 

NHS England Guide to reducing long hospital stays, June 2018

Helping people out of hospital takes focus and determination. At the moment we are working with many hospitals providing intensive support to help speed up discharge. Because we are a dedicated family liaison workforce with unparalleled knowledge of local care provision, we can make a big difference the minute we have boots on the ground. We can deploy within two weeks and our KPI for discharge is five days from referral. This is making a real difference to day to day operations in these hospitals. 

We’ll soon have a new government and in the run up to his election we have all heard ad nauseum about how they would ‘fix the NHS’ whether that is building more hospitals, a milkshake tax, a public drug company or ending hospital parking charges. The solutions to social care were notably absent. 

We need a proper grown up public debate about how we want to care for our elderly and those that need complex care. What’s missing for me in the relentless headlines is what it feels like for a patient and their family when they are faced with choosing care – the options, funding models and maze of processes and assessments. The lack of investment in social care may also be exacerbating the perception of risk from medics for older people going home. If you are caring for a patient and you lack confidence in what support is available for them in the community, you may be less inclined to send them home. There is a big challenge here but also an opportunity to build a system which is integrated and not about protecting siloed budgets. 

All of this will take time. What we can do this winter is help people ready to leave out of hospital and into the right care in the right place, quickly and safely and that will make a difference immediately. Let’s get started.

CHS hospital discharge management

By Uko Umotong

At CHS Healthcare we coordinate hospital discharge so that patients transition smoothly into the right care for them. Our work begins as soon as a patient is referred, even if this is in the evening or on the weekend. Patients are individually assessed for their needs and the appropriate care is arranged. Transfer from hospital into the right care typically happens within five days of the referral.

What’s best next? Long term focus and dedicated resource

By James Maxwell

We’re now well into autumn and looking ahead to another challenging winter for the NHS.

One thing that stands out about this winter is that by the end of it (March 2020) NHS trusts should have realised the national ambition announced by the Secretary of State in 2018 to lower bed occupancy in hospitals by reducing the number of long-stay patients (21 days or more) by 40% against a 2017/18 baseline.

As our recent research revealed, trusts are struggling to meet their targets around reducing super stranded patients with 90% of them way off the initial 25% target, let alone the 40% expected by March 2020.

Over the last month, the government has made a flurry of health-related announcements. What’s interesting about these is that many have felt slightly old fashioned and about the infrastructure rather than the patient:

  • Spending £2.7bn on building hospitals
  • Keeping bed numbers steady (and increasing bed numbers)
  • Creating an investigations Arm’s-Length Bodies (ALB)

At the same time long promised plans for social care reform remain stubbornly vague.

While the recent announcements may reassure people that the health system is in good shape and money is being spent on visible elements of the system, the picture at the back door is very different. The health system is increasingly dynamic and solving challenges like reducing the number of older people who are in hospital when they are medically fit for discharge is a team sport, which needs participation from across the sector. At its heart it’s a problem solved by focussing on the patient, especially bearing in mind the negative impact on mental and physical health of a long stay in hospital.

The ‘Where best next’ campaign from NHS England and NHS Improvement outlines five key principles for supporting patients medically ready out of hospital and into care. One of these principles is centered on involving the patient and family in decision making. This is hugely important but often overlooked – we know that dedicated family liaison including after hours and weekend support makes a direct impact on how quickly patients can be helped into care. With our support The Hillingdon Hospitals NHS Foundation Trust was able to move 20 super stranded patients into care within 7.5 days.

Making sure resources are dedicated to the backdoor is the right thing to do for patients and their families, and will help the existing capacity in hospitals to be used for patients who need those beds and care.

CHS deliver the five principles

By Uko Umotong

We know trusts are struggling to meet their targets for reducing super stranded patients. As part of the ongoing efforts to support trusts to reach their targets, NHS England and NHS Improvement have worked with partners to identify five key principles to help ensure patients are discharged in a safe, appropriate and timely way. These principals reflect the work that we undertake with hospital discharge teams across the country. We all know staying in hospital longer than is necessary is harmful to elderly people. We work with trusts and aim to support people back home with care or into a care home within five days of referral. Get in touch below.

Are more beds really the answer?

By Gabrielle Silver

This week at NHS Providers, Simon Stevens spoke about acute hospital capacity heading into winter: “… we want to go into the winter with as many hospital beds open as we can – ideally more than last year. In June I said, looking at evidence, we should not be planning on the basis that there will be further reductions in acute hospital beds over the next five years, and [it’s] important, as people are doing their long term implementation plans locally, they are thinking carefully about that.”

But is this the right currency to focus on in terms of capacity? At first glance it seems logical that more beds should be considered a useful lever to create capacity over winter. However, when you set this against a backdrop of 350,000 patients spending more than 21 days in hospital, trusts missing targets on helping these super stranded patients out of hospital and into care, as well as many trusts already using escalation beds, it seems that the real capacity in the system is unknown. The beds that should be made available are those that are occupied by these super stranded patients – until these beds are put back into the system can we really be sure that there is a need to open and staff ‘new’ beds?

A practical and achievable intervention to release this capacity is intensive working with the family and carers of patients. We’ve been working with trusts undertaking family liaison for many years and have seen first-hand how dedicated support focussed on understanding patient needs, being available after hours and at weekends, as well as taking family members on visits to care homes can support them to make an otherwise daunting decision. With this all round approach, we discharge all patients in 10 days or less. It’s this support which could really make a difference over the coming months without the need to put more beds into a system which struggles to cope as it is.

At CHS Healthcare we’re family liaison experts

By Uko Umotong

At CHS Healthcare we’re family liaison experts. Our approach is flexible and adaptable so that we’re available when families need us. We work evenings and weekends because that’s when families are free to talk, take families on care home visits, and have teams based at hospitals. We are advocates for the right care for the right person in the right place and we put this at the forefront of what we do.

Don’t just take our word for it though: “I just wanted to say thank you for your help in finding a home for our dad. I can’t say how much it helped at a stressful and difficult time, in particular your promptness in responding to any queries and your support by telephone.” – Family member

CHS Healthcare works alongside the NHS and social care colleagues on ‘Long Stay Wednesdays’

By Uko Umotong

Uko post – CHS Healthcare works alongside the NHS and social care colleagues on ‘Long Stay Wednesdays’. This brilliant team at Kettering General Hospital have been nominated for a HSJ Award recently, so we asked Rebecca Smith (CHS Coordinator) to tell us how it works and why it’s so important to ensure the right care in the right place for every patient.

Long Stay Wednesdays – making a huge difference at Kettering General

Long Stay Wednesdays is an initiative launched in August 2018 at Kettering General Hospital NHS Foundation Trust. The purpose of Long Stay Wednesday is to give dedicated focus to those patients who have been in hospital for more than 21 days.

Rebecca Smith, coordinator at CHS Healthcare explains how it works and what impact it’s had.

We have been commissioned by Nene CCG to support patients being discharged from Kettering General Hospital into long term care placements, Discharge to Assess (D2A) for reablement or home with a package of care since December 2016.

At Kettering General, the CHS team are located within the integrated discharge team (IDT) and we work alongside the hospital discharge teams to help people out of hospital and back to their own home with support or into care. We liaise with patients and their families to understand what help they need and what type of care home would be the right fit. We also work extremely closely with local care providers so that we know what availability they have and what facilities they have to make sure we can provide high quality referrals and they can make decisions more quickly.

How do Long Stay Wednesdays work?

Each Wednesday a team of key senior staff meet with ward teams and us and look at what needs to happen to help patients to leave hospital.

The specific focus of the long stay team is on ‘super stranded patients’ – those who have been in hospital for more than three weeks. Often these patients have been in hospital for longer than usual for complex reasons including rehabilitation and challenges to get the appropriate support arranged outside of hospital.

What do CHS do to support Long Stay Wednesdays?

Our role at is to update the team and wards on any of the patients that we are working with. We also offer advice and challenge so the team can start to really understand why a patient is unable to leave. Sometimes we might suggest a different pathway for a particular patient and because we know the local care provision so well, we might have solutions that haven’t been thought of already – for example units and hospitals that are most appropriate for specific illnesses.

We screen all patients on to the Continuing Healthcare (CHC) D2A pathway. At Long Stay Wednesdays we can ask about CHC needs and if none present, we can suggest an alternative pathway.

We also manage all the self-funding patients. We regularly received self-funders that we can’t support as they don’t have capacity or power of attorney. We also support with family and choice delays by ensuring we involved the patient and their families in discharge decisions. Long Stay Wednesdays provide an opportunity to explain the challenges and to support the ward teams and social services colleagues.

Why are Long Stay Wednesdays important?

For me, Long Stay Wednesdays is a knowledge sharing day. By getting together and talking through patients we are able to agree the best, safest and quickest route out of the hospital. This means patients avoid yo-yoing between pathways.

I also feel that being a non-clinical member of the Long Stay Wednesday team is an advantage as we can see things in its simplest form and sometimes removing the medical aspect can make things a lot clearer.  Our moto in Nene is very much “why?” which fits with Long Stay Wednesdays.

I am very pleased that the Long Stay Wednesday team has been recognised as a finalist for the HSJ Awards. Being part of the team is hugely rewarding and we have done an amazing job – in July 2018 Kettering General had an average of 195 super stranded patients on any one day – 12 months on this is 100 patients. That speaks for itself!

Last year over 330,000 patients were in hospital for 21 days or more

By Dr Gabrielle Silver

Last year over 330,000 patients were in hospital for 21 days or more – making them ‘super stranded’. NHS England and NHS Improvement have set trusts the target of reducing the number of long-stay patients by 25% and then by 40%. It’s an important target because as well as supporting flow through the hospital it creates a focus around doing the right thing for these patients – who may be more complex than many.

The reality is almost 90% of trusts are not meeting their ambitions for these super stranded patients. Day to day we see how focusing on the individual and their family with dedicated liaison and support is the key to better discharge. It’s a practical and straightforward solution that will also go a long way to drive progress around these targets.

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