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Reducing hospital conveyance/attendance

  • Our transfer hub is open extended hours 7 days a week (for contracted organisations) to take urgent referrals from primary care/local authority/community urgent response teams - sourcing care when needed.

  • Securing urgent home care will support/enable acute community recovery and help to avoid conveyance to an acute hospital unless there is an urgent clinical need to do so.

  • This relieves pressures on Emergency Departments, Acute Frailty Assessment Units, Acute Medical Assessment Units and SDEC, especially out of hours and over weekend/bank holiday periods, and helping to optimise ambulance availability in the community.

Co-ordinating urgent home care

  • We have access to a wider network of home providers allowing us to source rapid care provision - especially for those able to self fund or Direct payments with top up.

  • We can quickly titrate care provision with care needs.

  • We support providers to ensure a reablement approach where this is clinically possible, thus maximising independence and helping to limit health deterioration in frail/older people.

Reducing avoidable hospital admission

  • Our temporary live-in carer solution recognises that a lack of overnight care/supervision can be a deciding factor to admit (in the absence of a clinical reason) - especially out of hours.

  • We have access to an increased pool of home care providers/solutions meaning there is more available community care capacity - increasing the chance of sourcing care quickly to avoid unnecessary hospital admission.

Co-ordinating urgent home care to optimise 'front door' discharge

  • We have access to a wider network of home care providers.

  • We have the ability to quickly source temporary live-in carers where this is recognised as an admission prevention solution, and over 50% of our live-in carers are interested in 1 week+ assignments - enabling continuity of care.

  • Extended transfer hub availability ensures responsiveness to the typical ED hourly attendance peaks, especially around arrival times for frail older patients.

Co-ordinating flow into, through and out of D2A pathways

Via our transfer hub, we work in conjunction with/as part of existing Integrated Discharge Teams/Services/Hubs to source care to support all 3 D2A pathways and minimise delays.

Pathway 1

  • We can source additional home care capacity/providers for self pay and direct payment with top up patients. This can release existing reablement staff (where they may be 'plugging' domiciliary care gaps) to focus on attendance/admission avoidance care.

  • Our 'Carers Direct' model provides additional homecare - as an introductory agency we can provide personal assistants direct to clients who then weekly contract them to provide the necessary support at home.

  • For 'Carers Direct' we operate a sustainable recruitment model - 70% are recruited from a non-agency/care home employment eg: self employed carers already operating/dormant health and social carers brought back to care.

Pathway 2

  • As part of proactive discharge planning within this pathway, we can expertly broker/source either home care or care home placement.

  • Our ability to source live-in care helps maintain independence and reduce the number of care home placements - making best use of available community capacity and reducing LOS in pathway 2 beds.

Pathway 3

  • We can broker additional care home capacity and this can help release existing 'core' care home capacity back into the system.

  • We have experience of working with providers to stimulate the care home market and add resilience, including mobilising D2A-specific contracts/service specifications, and helping them further develop and implement the required reabling approaches to both manage LOS within the pathway but also deliver better long term outcomes for people (some may be able to return home from pathway 3 with live-in care solutions that we can access).


If you think we can support you with improving patient flow and discharge in your health and social care system then please get in touch with us to arrange an initial discussion/meeting:


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