Midland Heart: Innovative Solutions to Hospital discharge

‘Ward D47’ Sandwell and West Birmingham City Hospital: Sandwell WB NHS Hospitals Trust

Midland Heart have worked with both acute and community trusts to develop reablement units. Each of the units are refurbished wards, created to reflect a more homely and less clinical environment. Through a joint trusted assessment team, older individuals deemed medically fit for discharge and who do not require an acute bed, are placed into the service.  The reablement team then create a personalised support plan, to meet the social care needs of the customer whilst continuing their discharge journey home. Midland Heart’s team of reablement workers deliver a programme of activities which focus on wellbeing, confidence building and independence, as well as ensuring that an ongoing care package is arranged or necessary adaptations are fitted to make the transition home smooth.

Key features

  • A step-up and step down refurbished ward within the main City Hospital building. It has 20 flexible community care beds for customers aged 18 or over (but vast majority 65+).
  • This service is nurse led with staff employed directly by SWB HT and is CQC registered under the hospital’s registration. The responsibility of medicine management and care planning at D47 lies with the hospital’s nursing staff (there is one nurse per shift) whilst Midland Heart’s reablement workers focus on working with customers to achieve the reablement goals outlined in their care and support plans.
  • Referrals to D47 are made via a single point access triage service who will screen their needs and identify the most appropriate place to meet these needs. This is solely overseen by the hospital nursing staff.
  • The average age of patient is 80 and the average length of stay is 9.4 days, with 85% being discharged to their usual place of residence.