This guest blog was contributed by the New Care Homes Programme at NHS England.
Sometimes the simplest ideas are the best – and one that’s spreading fast is the hospital red bag.
First conceived by the Sutton Homes of Care vanguard, the red bag – more formally known as the hospital transfer pathway – is having a definite impact.
Care home residents are more than three times as likely to be admitted to hospital as other over 65-year-olds. Visits can be confusing, particularly as eight out of 10 residents live with dementia.
The red bag makes transfers in and out of hospital more streamlined for hospital staff, care homes staff, first responders – and the patient.
It contains key health information in one place, along with more personal belongings – glasses, hearing aids, clothes. It stays with the patient and is easy to identify by all professionals involved.
Care home residents are getting safer, faster, more personal treatment in hospital.
Hospital and care home staff spend less time dealing with calls about the patient. The resident is often discharged sooner – on average four days earlier – which is beneficial to them and relieves pressure on wards. Overall, their continuity of care is more assured.
William Roberts, NHS England’s lead for enhanced health in care homes, says: “This is a brilliant innovation. While the concept is simple, and relatively quick to introduce, success is dependent on building relationships across the patient pathway and changing the culture.”
The concept was developed by NHS Sutton Clinical Commissioning Group with Epsom and St Helier Hospital Trust, Sutton and Merton Community Services, London Ambulance Service and Sutton care homes.
Other new care model vanguards including Wakefield and East and North Hertfordshire, have launched similar schemes.
For those wanting to adopt the red bag, there are lessons to be learned.
NHS Sutton’s Christine Harger says: “This is an integrated care pathway spanning care homes, community services, ambulances and hospitals – every touchpoint a care resident might have. All partners must be involved – don’t shortcut the process.”
Communication and engagement has been pivotal.
“We put tremendous energy into communication and training,” says Christine. “Change agents in the hospital were running engagement events. We engaged all ambulance staff and trained care home staff. Hospital screensavers promoted the scheme which was also incorporated into induction for new starters and safeguarding training.
“Very quickly, the red bag was established and we are making sure it stays that way with checks built into the hospital’s quality audits.”
Patient consent was a crucial element.
“Consent gives doctors and nurses permission to talk directly to care home staff about their patients. This has secured earlier discharge and better continuity of care,” says Christine.
In East and North Hertfordshire, project manager Anna Makepeace says: “We ran a pilot but relaunched again in July. We struggled initially with the scale of the pilot which involved just 10 of our care homes. It wasn’t big enough for the cultural change needed among hospital staff. We also streamlined the forms included in the red bag.”
Ownership from the bottom-up is a common theme.
Wakefield’s Connecting Care senior project manager Lesley Carver says: “Strong partnership working, across care homes, the ambulance service and hospitals, ensures professionals are part of early discussions. Organisations then take responsibility and secures complete buy in.
“Planning was the most important lesson, specifically getting everything lined up for a successful launch. Implementation takes about four months, so all organisations need to commit this time.”
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