Expert Clinicians back approach to helping patients get back to their own homes

Advice by leading medical experts has backed plans to help patients in North Staffordshire and Stoke-on-Trent get back home once they are considered well enough to leave hospital.

It concluded that the system, known as Discharge to Assess (D2A) is “effective and carefully considered”. The approach is helping patients get back home with appropriate support, and is the local implementation of a nationally recommended approach.

The report, North Staffordshire and Stoke on Trent CCGs Community Hospitals and Discharge to Assess, is published today by the NHS West Midlands Clinical Senate.

The senate is part of NHS England’s Assurance process to make sure that proposals for changes to health services are safe, meet patients’ medical needs and are of high quality. The senate is made up of expert clinical leaders who provide strategic advice and guidance to NHS England and commissioners to assist them make the best healthcare decisions for local patients.

The senate is part of the assurance process that the CCGs must go through before consultation into the future of local health services and community hospitals can take place.

D2A is replacing a system that used to see patients who were fit to leave Royal Stoke University Hospital (RSUH) either assessed in the hospital before they were allowed home, or instead sent to stay in a rehabilitation bed in a community hospital. In some cases patients stayed in a hospital bed for many months waiting for another service.

The senate made a number of recommendations which will be included in the next stage of the assurance process and concluded,  “on balance we were convinced of the clinical merits of the model, and that it would offer improved patient care. On that basis, subject to the active consideration of our recommendations, we support the proposed model.”

It added: “The West Midlands Clinical Senate Council concluded that it supports the CCGs’ proposals for a reduction in community hospital beds replaced by an increase in place based care.”


Dr Steve Fawcett, Medical Director of North Staffordshire and Stoke-on-Trent Clinical Commissioning Groups (CCGs) said: “We would like to thank the members of the senate for their expert advice which we believe is fair, well considered and completely objective. It is part of the vitally important assurance process which makes sure that proposals are safe and robust.

“They have made recommendations in a number of areas including staffing, public engagement, capacity in nursing and residential homes, managing clinical responsibility and best practice. We will make sure that all of these questions are answered in the next stage of the assurance process. Until that process is complete, we cannot go ahead with our long awaited consultation but it is right and proper that we go through the process.   

Tracey Shewan, Director of Nursing and Quality for the CCGs said: “Clinical evidence shows that staying in a hospital bed when you don’t need to be there, either in an acute hospital like the Royal Stoke or a community hospital, is harmful for frail and elderly patients. They quickly lose their physical strength and self-confidence. The sooner we can get people home to be as mobile and independent as possible, the better their mental and physical health is.”