A NEW approach to helping patients who need home support leave hospital early has saved the NHS more than £1million since it was introduced as a core service in East Lothian three years ago.

The Discharge To Assess (D2A) team in the county is now estimated to be saving NHS Lothian £300 a day by releasing hospital beds early.

And they are continuing to get people home despite lockdown, with more than 50 patients discharged through them last month alone.

Thanks to smart house technology and Skype, they are making sure families can keep in touch with vulnerable adults in hospital and at their homes while they are unable to visit.

Launched three years ago, as part of East Lothian Health and Social Care Partnership, the team’s approach involves bringing community therapy services and primary care together to ensure East Lothian residents who are admitted to hospital can return home as soon as possible.

Many of the patients returning home require stroke rehabilitation or orthopaedic support and the D2A focus is on making sure they can receive this at home, instead of having to undergo therapy in hospital before they are allowed to leave, causing delays.

This approach, which involves daily discussions with hospitals and families of patients, has allowed more people to return home more quickly, releasing beds early and saving an estimated £1,048,000 since the service began three years ago.

And, even in lockdown, the team are continuing to maintain the flow of patients returning home using a range of technology.

At East Lothian Community Hospital, the occupational therapy and physiotherapy team have been using Skype video calls to aid communication with families not able to visit their relatives due to Covid-19 visiting restrictions.

Ruth Aspinall, occupational therapist, said the hi-tech communication was proving invaluable.

She said: “Within the ward environment we have used Skype video calls on various occasions to enable links with family and promote discharge planning/discussions.

“This has been invaluable in the current climate, when families are unable to visit wards.

“Skype video call was used with one patient who had had a stroke and whose family felt unable to engage fully in discharge discussion, as they had not seen their family member since admission.

“Skype was used to allow the family to see their relative’s level of function and mobility and this enabled the discussions regarding discharge to progress.

“We have also used Skype video call to have a meeting with a patient and her son to discuss issues around discharge.

“These have been extremely beneficial and highlighted there would also be benefits to using this at various stages in patient stay, rather than just verbal updates.”

And one relative gave feedback to the team, telling them: “We found the use of Skype video call a good source of encouragement, and gave us confidence to move to the next stage in planning.

“We gained reassurance from seeing [our relative] moving rather than just being verbally updated. We found this beneficial.”

Hi-tech solutions are even being found to monitor patients who live alone once they have returned home, with a system called Alcuris, which tracks their use of household devices.

The team revealed one East Lothian resident who lived alone used Alcuris to give peace of mind to his son, who lived in another town.

The smart house technology records use of devices, which can be monitored on an app by relatives.

The man said: “A different family member calls me every day and, should something have happened to me overnight, they may not realise that something’s wrong until they phone.

“This system allows my son to check that I am using the kettle, moving around, doing my usual routines and that I am safe.”

Alison Macdonald, chief officer of East Lothian Health and Social Care Partnership, praised the D2A team for their innovative use of new technology and joint working to help keep residents home and safe.

She said: “So far the team have helped 1,165 people to get back home safely, where they should be, and I want to say ‘well done’.

“They make such a positive difference to patients and their families.

“The integrated health and social care team have played a key role in ensuring East Lothian residents do not experience a delay in their discharge home and are also starting to support people who could benefit from their expertise to avoid admission to hospital in the first place.

“We are pleased that East Lothian Integrated Joint Board has supported this development from a small test of change to a fully funded, core integrated service.”