Local patients to benefit from Home First approach

NHS Western Isles is emphasising the importance of the Home First approach for patients to recover at home once medical treatment is complete. This strategy aims to help people maintain their independence as much as possible as they recover from hospital stays.

While the hospital is the best place for medical checks and treatments, it’s not the best place to recover once you’re well enough to go home. Staying in hospital when you’re well enough to go home can:

• reduce independence
• reduce muscle strength
• and increase your risk of infection.

By recovering at home, you reduce the chance of physical and mental health problems which can occur when you spend too much time in a hospital bed. Being at home can also reduce the risk of infection and let you get back to your usual routine.

How does Home First work in practice?

Discharge Planning

Planning for discharge begins as soon as you are admitted to the hospital. The goal is to discharge you once your medical needs can be met outside the hospital, which is crucial for patient wellbeing.

Discharge Plan

A discharge plan should be in place before you leave the hospital, covering your medical condition, medications, ongoing treatments, and any required services or equipment. Family members or carers and crucially, you as the patient are entitled to be involved in this planning process.

Assessment

You will work with your medical team to determine when you’re ready to leave hospital. This team may include doctors, nurses, social workers, occupational therapists, and other specialists such as physiotherapists and dieticians.

Discharge Options

Based on the assessment, several discharge options are considered:

• Immediate discharge with little or no ongoing care needs
• Discharge with short-term support, known as reablement care
• Discharge with long-term care needs, which will involve creating a care and support plan
• Discharge to step-down or intermediate care for intensive short-term support

Types of Discharge

• Home with Short-term or No Care Needs: Local councils may arrange short-term care.
• Home with Long-term Care Needs: A care and support plan will be developed, detailing the services provided and associated costs.
• Step-down Care: For those who need intensive support temporarily, care may be provided in residential settings or at home.

Care Home Discharge

If returning home is not feasible, the council may recommend residential care. You have the right to choose a care home, provided it meets your needs, is willing to accommodate you, and costs within the council's expected rates.

Paying for Care

Costs for care vary by council area. Personal and nursing care is provided free if assessed as needed. Charges may apply for domestic assistance, and a financial assessment will determine your contribution.

Self-Directed Support

Self-Directed Support allows you to choose how your care budget is spent, offering options from direct payments to council-managed services.

Preparing for Discharge

Before leaving the hospital, ensure:

• You have necessary personal items and a way to get home
• You understand your medications and have a supply
• Any required equipment is ready, and you know how to use it
• You know the local support available, and your GP is informed

For more information on discharge planning and what happens before you leave hospital, you can visit our website: About your discharge – NHS Western Isles | Serving the Outer Hebrides of Scotland.