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INNOVATION

Supporting discharge using a volunteer scheme

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The Royal Volunteer Service’s Home from Hospital scheme provides support for at-risk older patients and has already helped to reduce hospital readmission rates

Citation: Rivers S (2015) Supporting discharge using a volunteer scheme. Nurisng Times; 111: 23/24, 22.

Author: Sally Rivers is hospital strategy lead for the Royal Voluntary Service.

Introduction

It is estimated that older people are more than twice as likely to be readmitted to hospital if they are not given enough support on discharge (Royal Voluntary Service, 2014). In response to this, the RVS established the Home from Hospital scheme. Volunteers work alongside NHS staff on wards to identify patients who would benefit from the service.

The service focuses on at-risk patients - those who are aged over 75, living alone or with long-term health conditions. Once an older person is medically ready to leave hospital, volunteers are there to help facilitate the discharge process. The aim is to avoid delays and free up beds for other patients.

Supporting discharge

The trained volunteers can prepare patients’ homes in advance of their arrival by making sure the heating and lights are on and that the kitchen is stocked with essentials. Once patients are home, volunteers can offer companionship and carry out simple tasks such as helping with shopping, collecting prescription medication and providing transport to medical appointments.

The volunteers aim to help rebuild older people’s confidence, enabling them to pick up the reins of their old lives. Volunteers can refer on to other services and help plan longer-term social and practical help, for example suggesting community transport, repairs, adaptations and benefits advice. Above all they offer their time and a friendly, listening ear.

The Home from Hospital service lasts for an initial six weeks, but the RVS keeps the support going long term. Once the programme ends, older people are moved seamlessly onto the Good Neighbours community service. This offers befriending, either face to face or over the phone, community transport, lunch clubs and opportunities for older people to get involved as volunteers themselves. This wrap-around support helps maintain well-being and fosters resilience for the future. See Box 1.

Box 1. Case study

Joan Meredith, 81, was in hospital following a stroke. Although she had been very busy and outgoing beforehand, her confidence had ebbed away since her hospital stay. Mrs Meredith’s daughter arranged for a volunteer from RVS to visit when her family could not be there.

Mrs Meredith was matched with Susanne, who has helped her about the house and to go out for walks, and has expressed how much she appreciates Susanne’s visits: “It’s the little things that make a difference, the things I can no longer do that Susanne can help me with. It’s an excellent and well-organised service, for which I am very grateful.”

Evaluation

The RVS currently has Home from Hospital schemes operating across the UK. Evaluation of the schemes to date has shown tangible benefits. The service in Leicestershire, which has been monitored for the past two years, has shown very low readmission rates to hospital among the more than 900 participants. Only 8.35% have been readmitted within 60 days of being discharged, compared with national figures of 15% in 30 days. Older people who have used the scheme are overwhelmingly positive. The majority of users in a survey conducted by the RVS in 2013 reported feeling more optimistic about the future, more confident, better supported and more likely to get their old life back.

Conclusion

Placing a caring volunteer at the centre of older people’s recovery plans can be beneficial. Having someone come around at a difficult time of their lives to carry out simple tasks dramatically improves their experience, confidence and wellbeing and helps them continue to live independent, fulfilling lives.

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