Home first, intermediate care and discharge
Our approach
We work across NHS organisations, local authorities and community providers to redesign and improve intermediate care and discharge services that deliver better outcomes for people and better value for systems. Our approach combines pathway redesign, operational improvement, commissioning expertise and frontline implementation support to ensure change translates into measurable results.
Areas of expertise
- Home first model design and implementation
- Discharge pathway improvement
- Intermediate care redesign
- Reablement transformation and strengths-based practice
- Step-up and step-down models of care
- Transfer of Care Hub optimisation
- Length of stay reduction programmes
- Patient flow and discharge improvement
- Demand, capacity and workforce modelling
- Intermediate care commissioning reviews
- Service specification development
- Benefits realisation and impact measurement
Delivering improvements
Our programmes help people recover faster, maintain independence and reduce avoidable demand on health and care services. Typical outcomes include:
- More people discharged to their own home
- Increased independence following discharge
- Reduced length of stay
- Reduced discharge delays
- Lower rates of readmission
- Reduced demand for long-term care and support
- Improved utilisation of intermediate care capacity
- Better patient and carer experience
- Stronger integration between health and social care services
- Measurable financial benefits and system efficiencies
Our approach
We work across NHS organisations, local authorities and community providers to redesign and improve intermediate care and discharge services that deliver better outcomes for people and better value for systems. Our approach combines pathway redesign, operational improvement, commissioning expertise and frontline implementation support to ensure change translates into measurable results.
Areas of expertise |
Delivering improvements |
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Our programmes help people recover faster, maintain independence and reduce avoidable demand on health and care services. Typical outcomes include:
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Frailty: The biggest opportunity to close the gap
Frailty accounts for 20% of all NHS bed days. Preventing 5 frail admissions per day is equivalent to 60 beds per annum.
Care at home / in community
Care in acute build
Care at home / in community
Care at home / in community
Care in acute build
Care at home / in community
HEALTH OUTCOMES WE DELIVER
More people living independently for longer.
Reduced avoidable (re)admissions.
Reduced LOS and delayed discharges.
Stronger integrated neighbourhood partnerships.
Optimised health and care resources and measurable financial benefit.
BEST PRACTICE THROUGH BEHAVIOUR AND CULTURE CHANGE
Valuing home
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Fewer hospital admissions
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Shorter hospital stays
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Fewer discharge delays.
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More discharges directly home with reduced reliance on long-term adult social care intervention.
Case studies
Transforming patient flow at Nottingham University Hospitals
Supporting Hampshire Hospitals NHS Foundation Trust with Dynamic Activity, Workforce, and Finance Modelling
IMPOWER applied its proven methodology, previously used across four New Hospital Programme (NHP) Trusts.
Identifying new opportunities to improve outcomes and save money in Manchester
Delivering sustainable discharge and flow improvements across East Surrey
Relieving pressure on acute beds and improving outcomes in Lincolnshire
Designing and implementing an effective model for patient discharge and flow that’s owned and championed by practitioners
Embedding a ‘home first’ ethos for patients in Manchester and Trafford
Ushering in a culture shift and new model to drive better outcomes for hospital patients
IMPOWER’s ability to set out complex data in a meaningful and engaging way has further helped keep our momentum of improvement… Remaining focussed on what is best for our patients and keeping patients at the centre of our ambition throughout. Being able to work across many partners and understanding the importance of reaching collective agreement and building relationships to enable this was powerful.
In Manchester University NHS Foundation Trust (MFT) we are lucky to have world class clinicians and the success of Hospital at Home has been driven by our clinical leaders, who are delivering innovative practice which is improving the outcomes we achieve for our patients. IMPOWER have given us the structure we need to drive this work, have worked alongside clinical teams so they feel supported to innovate, and have used their expertise to demonstrate impact and build the case for change.
Reports
Healthy Homes in the East of England Report
How ICSs can support collaboration to deliver better housing and health outcomes in the East of England.
Academy of Medical Royal Colleges AoMRC Report
Explore why we have not yet delivered the long-promised shift to more home and community-based care.
Intermediate Care – joint report with ADASS
We have emerged from Covid needing to support higher numbers of people, in the context of ever straightened financial circumstances.
The evolving role of county authorities in Integrated Care Systems
