Case studies

Prior to the move into the discharge hub, work had already taken place to replace the ward discharge Officers with a more administrative role, new staff were recruited at band 4 on each ward within the Trust. A decision was also made that each directorate would have a supervisor Band 5 post to over-see the work of the discharge officers. This example of a local initiative forms part of our managing transfers of care resource.

The Trust decided to implement an electronic system to find a better way of managing complex discharges in 2013. This was developed in APEX, a low-code development platform that enables an organisation to build scalable and secure apps. This example of a local initiative forms part of our managing transfers of care resource.

‘Transforming our Communities’ was a consultation undertaken by Hambleton, Richmondshire and Whitby, and helped to provide a mandate for the local system to develop new models of care closer to home. This example of a local initiative forms part of our managing transfers of care resource.

In late 2017 the Technology Enabled Care (TEC) team began working on a project to improve pathways and access to TEC for those who were being discharged from hospital. The aim was to significantly increase the take-up of lifelines and telecare within a vulnerable cohort that would most benefit from them and ensure that people had access to the councils in house Reablement Enhanced Response Service (ERS). This example of a local initiative forms part of our managing transfers of care resource.

NHS Newcastle Gateshead clinical commissioning group (CCG), was selected to be part of NHS England New Care Models Care Home Vanguard Programme. One of the initiatives to be introduced was the ‘transfer of care bag’, which sought to improve communication between hospital and care home teams when residents moved between both settings. This example of a local initiative forms part of our managing transfers of care resource.

The East Midlands Association of Directors of Adult Social Services (ADASS) Network group commissioned a project on how to assess the risk of market failure at a regional and sub-regional level. This project was based on the premise that early communication between authorities can enable interventions to prevent market failure, or help manage the impact of any failure. The project was supported by the LGA through the Care and Health Improvement Programme (CHIP).

A new integrated adult Community Learning Disability (LD) Team has been uniquely co-located with children’s social care and education services in purpose-designed premises to improve outcomes for residents of all ages with disabilities.

Greater Manchester H&SC Partnership decided that a resource pack would be a useful resource to create to promote innovation, best practice and improve commissioners understanding of workable models of housing with care.

Following the development of the wellbeing offer for NHS staff affected by COVID-19 in April 2020, the NHSE & I regional team in the south east of England felt that there needed to be a similar resource for social care staff.

In Barnsley, South Yorkshire, a Macmillan Social Worker is employed by Barnsley Council to sit within the multidisciplinary team of clinical nurse specialists, occupational therapists and dieticians to provide expert support for people in need of complex palliative care and support at end of life. This case study forms part of our end of life care guide for councils. This case study forms part of our end of life care guide for councils.