National Institute for Health and Clinical Excellence (NICE)
In the bag - making moving between hospital and social care better
A simple ‘red bag’ has helped to speed up and improve the transfer of patients between hospital and care home settings.
Sutton Clinical Commissioning Group (CCG) developed the simple and novel approach to follow NICE guidance on the transition between hospital and care home settings. Each person moving between hospital and care home is given a red bag to store their paperwork, medicines and belongings. Using the bags has improved care and ironed out potential problems for patients and their carers that can cause confusion and delay.
Delays in the discharge of patients place a huge burden on the NHS. Figures show that more than a million hospital days were lost due to delayed discharges in 2015. In 2012-13, more than a million people were readmitted to hospital as an emergency within 30 days of discharge. This costed the NHS £2.4 billion.
Sutton CCG found the lack of a standardised handover process was leading to poor quality of care in its area.
Ambulance crews were being delayed while care home staff put paperwork together. Medical teams were making frequent calls to care homes to get information on home residents. Personal belongings were also not being transferred or were often lost while residents were in hospital.
Furthermore, many residents were arriving back at care homes without the right medication, treatment information, or changes to their care plans.
Improved communication, speedier transfer times
To tackle this, Sutton introduced its ‘Red Bag’ initiative. The bag stays with the resident throughout their stay at hospital and is returned home with them following discharge.
Through standardising the paperwork all who care for the person have the information required about their general health. When they are discharged, a ward nurse ensures all the paperwork is included, such as a discharge summary, and an older person’s assessment form.
So far, the red bag scheme has led to:
- improvement in communication between hospital and care homes
- reductions in ambulance transfer times and A&E assessment times
- a decrease in the number of avoidable hospital admissions
A ‘strikingly simple’ method of improving care
Viccie Nelson, Care Home Director at Sutton CCG, said: “Since we’ve carried out the red bag initiative, we’ve had positive feedback from both care home staff and residents’ families. It has improved communication, speeded up transfer, and reduced the number of calls that the hospital makes to the home from around 5 or 6 for each resident to just 1.
“At Sutton we’ve focused on improving the quality of care for those in care homes. NICE guidelines have helped this project by to showcasing best practice and providing neutral territory for us as an organisation to agree on good quality care.”
Listen to Viccie Nelson and Christine Hargar, Quality Assurance Manager with Sutton Care Home CCG, talk more about the project.
Professor Gillian Leng, Deputy Chief Executive of NICE, and Director of Health and Social Care, added: “It is important that people experience a smooth and timely transition from hospital back to their care home or own home. This can help improve a person’s experience of care and their quality of life. It also eases pressure on hospitals, and avoids people becoming caught in a ‘revolving door of care’ when they get readmitted to hospital.
“Sutton’s red bag approach is an innovative way tackling these problems, yet is striking in its simplicity. We wish them success in their project, and look forward to seeing further results as it progresses.”
Sutton CCG is one of four NHS vanguards that NICE is sponsoring. Listen to Chris Elliot, a GP and clinical lead at Sutton, talk more about how he feels Sutton’s vanguard status will help improve care.
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