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CNO launches support package to help boost safe discharge of hospital patients in winter

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The chief nursing officer for England has launched a new winter framework designed to help nursing staff to ensure that patients do not spend any time longer than they need to in hospital, calling on all clinical teams and nurse leaders to help “make a difference”.

The framework, drawn up by NHS England and NHS Improvement, is focused on maximising the use of care homes and use of therapy-led units for patients medically fit for discharge.

“I ask all nurse leaders to look at how they can maximise patient time and support therapeutic environments”

Jane Cummings

It been developed in “recognition of the pressure that can build in the system, with ensuing threats to patient safety, during the winter months”, said the two bodies.

The Best Practice Framework to support sustainability and transformation partnerships (STPs) and their provider organisations has a particular emphasis on maximising the use of care homes.

The framework covers providing support to care homes that may be at risk of closure, and making best use of available beds so patients do not have to stay in hospital longer than they need to.

It also describes therapy-led units where the focus is on reablement and rehabilitation, with a reduced reliance on clinicians, in order to create safer therapeutic environments for medically fit patients awaiting discharge.

“I want to acknowledge all the hard work that has gone into planning for the increasing challenges of winter”

Jane Cummings

In an accompanying blog, CNO Professor Jane Cummings highlighted the importance of clinical leadership in giving patients “the most precious gift, the gift of time”.

She noted that nursing leaders could locally ensure environments were created which focus on safe, effective and prompt discharge and where people can move around in their own clothes.

She cited figures suggesting that, for those over 80 years old, a week spent in bed can equate to 10 years muscle ageing, a loss of 1.5kg of muscle mass and a 20% reduction in aerobic capacity.

It can also lead to a five-fold increase in the risk of requiring institutional care and add to pressures on the NHS, added the CNO in her blog – titled Valuing patients’ time.

For example, in July 2017, in the North alone, if every patient was discharged just one day earlier it would have released 2,707 bed days for other people, saving the NHS £5.6m, said the CNO.

Professor Cummings said: “The last few months have been exceptionally busy in the NHS and I want to acknowledge all the hard work that has gone into planning for the increasing challenges of winter.

Jane Cummings, Chief Nursing Officer for England

Jane Cummings, Chief Nursing Officer for England

Jane Cummings

“Ensuring we build resilience in ourselves, our teams, in and across organisations is essential so we manage the months ahead with maximum certainty and confidence in our ability to provide safe care,” she said.

“While our time is busy and important, our patients’ time is sacred – let’s make giving back time by enabling our patients to return to the place they call home our challenge,” said the CNO.

“It’s one where every member of our clinical teams and every member of staff can have an impact and make a difference,” she noted.

She added: “I ask all nurse leaders to look at how they can maximise patient time and support therapeutic environments.”

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