Discharge to assess service developments

The CSP is encouraging members to take note of new guidance from the Department of Health on discharge to assess service (D2A).


It confirms the government’s and NHS England’s intention, made known at beginning of the Covid-19 crisis, that the D2A model developed in 2016 should now be rapidly rolled out nationwide.  

The D2A is a model for funding and supporting hospitals and local authorities to discharge patients from hospital as soon as its clinically safe to do so, with health assessments and continuing care subsequently delivered as close to the home as possible.

The new document looks to mainstream this model nationwide, while also prescribing a Covid-secure pathway for how patients should be discharged from hospital to care homes. 

With winter approaching and the significant body of evidence of the harm caused to patients when they remain in hospital unnecessarily, the roll out of the discharge to assess model is welcome and timely, said CSP professional adviser Claire Fordham.

‘I know of the enormous benefit this approach has to expediting discharge; supporting patients to recover well in the most appropriate setting and in driving a “home first” culture across acute and community services.’

However, Ms Fordham said, in her experience, the ultimate success of the approach depends on skilled staff who are enabled and supported to work in new ways.

‘This must include putting in place robust information sharing arrangements across acute and community settings; providing staff with adequate access to IT systems and developing clear governance processes.

Equally, sufficient capacity in the community to provide patients with the right level and intensity of rehabilitation and re-enablement support at home or other community setting is crucial. 

‘This is along with timely access to longer term social care and ongoing rehabilitation for those who need it following discharge from the pathway.’

A FAQ is being prepared explaining the impact this will have on CSP members and the factors that need to be considered in implementation.



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