By 2026, the NW London health and care system aims to enable 50,000 residents to spend 180,000 more days at home where clinically appropriate, with the right support for them and their families.
No one wants themselves or a loved one to be in hospital when they don’t need to be.
Evidence shows it is better for a patient’s physical and mental wellbeing to leave hospital as soon as they are medically fit to do so. By receiving care in their usual place of residence patients can maximise their independence, recover in familiar surroundings, and feel comforted by time with loved ones. All while pressure is reduced on the health and care system and patient flow is supported.
North West London is coming together to ensure that patients are not in hospital when they don’t need to be. We want everyone to receive care in the most clinically appropriate setting and to only spend time in a hospital, community, or mental health care bed when it is the best place to meet their needs.
As the innovation partner for NW London, we’re making this happen by testing and implementing impactful innovation. But innovation can only thrive when delivered collaboratively – we’re working in partnership with clinicians, system leaders, patients, charities and industry to ensure the right solutions are delivered in the right settings and delivering real impact.
To meet this ambition we are working collaboratively across NW London to prioritise innovations that tackle:
After a stay in hospital, most people are eager to get home as soon as possible, but the process for discharging a patient is incredibly complex. It requires multiple members of staff across different disciplines and expertise to be involved, sometimes across different sites or organisations. We’re focusing on testing and iterating innovations that support this collaboration across teams in multiple settings and provide an improved pathway, with a focus on patient need.
When individuals are in hospital for a ‘long-stay’ this can increase the likelihood of worse outcomes, as well as putting pressure on already stretched bed-occupancy. We’re focusing on using data science and AI to predict people most likely to be at risk of long stays (and readmission to hospital) to implement proactive and intervening support..
Want to learn more about how you can become part of our Innovation Networks? Email adam.ashworth@imperialcollegehealthpartners.com.
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We’ve spoken to NHS staff, patients and carers to better understand why enabling more days at home, and alleviating the pressures on our acute care system in NW London is so vital…
There’s no communication or communication channels between acute and community. And that causes frustration for patients. Now, for example, a patient will be discharged with a catheter. But there’s no communication to say the community nurses can insert a catheter on that patient or not. Without that, we can’t really change the catheter. So whenever there’s a problem, the patient has to go back to the hospital, which is frustrating because we could do that in the community in five or 10 minutes.
I had to stay longer in the hospital because the system couldn’t find the proper way of finding the services.
For my care package if they had all the information about me, [the] support system would have been much quicker.
We need to improve when we’re identifying patients and the ability to work on [discharge] plans a lot earlier. We work in a really reactive environment and that’s a cultural change that’s going to be a huge challenge to overcome.
I spend 90% of my time negotiating discharges for my patients. Sometimes I feel like I am the only one who can fight their corner and question the decline (for acceptance to a community bed). You need to be persistent to get anywhere as there is so much back and forth. Most of the time, all it needs is a phone call.
