Longer hospital stays can lead to greater dependence and longer term care needs. The CCG is keen to adopt the principle of ‘Home First’ to support more people in their own homes, providing as much care and treatment at home as possible.
Community inpatient services offer inpatient care for rehabilitation or recuperation for a person after their discharge from hospital following a period of treatment. Once a patient has had a hospital stay it is usually the patient’s preference that they return to their own home. This is particularly important for older people as research shows that 10 days bed-rest in a care setting leads to the equivalent of 10 years ageing in the over 80s.
Our Getting People Home Programme is at the heart of the CCG’s work to support people in their own homes. The programme aims to discharge more people home, with support, rather than them remaining in hospital. A clinical team of nurses and therapists visits the patient at home offering support such as physiotherapy and occupational therapy, often backed by voluntary sector organisations like Age UK Milton Keynes who provide a Hospital After care service to people who have been recently discharged from hospital.
If a patient is not well enough to return to their home, a community inpatient bed is provided as a place of rehabilitation and recuperation while the patient’s long term care needs are assessed. There are currently two pathways to access community inpatient services in Milton Keynes:
These are inpatient healthcare beds, for people who need a short period of rehabilitation before returning to their homes. Often, these are people who are less mobile at discharge can be helped to greater independence by intensive therapy. They may also require some overnight assistance at first.
There are currently 31 rehabilitation beds available in Milton Keynes: 19 beds in Windsor Intermediate Care Unit, Whalley Road next to Bletchley Community Hospital and 12 beds at Waterhall, Fern Grove, Bletchley.
These are inpatient social care beds and are for those who require a period of convalescence or recovery before they are ready to access reablement or rehabilitation services, or ready for their longer term care arrangements. There are currently 10 recuperation beds available in Milton Keynes, all at The Willows, Great Linford, Milton Keynes.
Why is change necessary?
The CCG is committed to providing as much care as possible to people in their own homes and if an inpatient stay is required for this to be as close to home as possible. We want to expand the steps we have made to achieving this through our Getting People Home Programme and apply the same principles to community inpatient care.
The current model of rehabilitation and recuperation beds is not flexible enough to allow timely and appropriate access for patients to community beds. The current approach uses access criteria for community beds for those patients who are not ready to be at home, but no longer need to be in hospital. This means that sometimes people stay in hospital longer than they need to.
By reducing the length of hospital stays, we will not only be able to care for more people in their own homes, where they tell us they want to be, but also to release financial savings that will help support the changes we want to make to care.
The proposal for community inpatient services
The CCG is proposing the following:
Community inpatient services will be offered through a flexible nursing bed base at a range of locations (31 beds currently) with specialist services and therapies such as physiotherapy and occupational therapy being offered to people in the nursing beds by Central and North West London NHS Foundation Trust.
More people will be cared for through the Getting People Home Programme and the specialist services and therapy services will be increased in people’s homes to reflect the expansion of this service.
As the Getting People Home Programme increases, it is likely that there will be less need for community inpatient services so fewer nursing beds will be required.
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