How volunteers help three NHS Trusts improve their discharge services
21st September 2021
In this recording, you will hear from the four speakers who explained how their volunteers provided discharge support to patients and how the serviced adapted to the changes caused by the pandemic:
· Laura Shalev-Greene, Head of Volunteering at Kingston Hospital NHS Foundation Trust: Fall prevention service
· Verity Barker – Volunteer Service Manager, and volunteer John Nunn at Royal Cornwall Hospitals NHS Trust: Going home bags and telephone follow up
· Jamie Goodman, Settle in service and community coordinator at Norfolk and Norwich University Hospitals NHS Foundation Trust: Settle in Service
The summary of the webinar can be found below with one of the presentations.
We hope you enjoy watching this recording.
Please note: the Q&A session is not included in this summary.
Speaker: Laura Shalev-Greene, Head of Volunteering, Kingston Hospital
View Laura's presentation here.
The Discharge Support Service has been running for three years
Three main points of focus:
1. Aims to improve patient confidence once discharged.
2. Increase patient connectivity to local community voluntary organisations in the Golden week and beyond (Golden week - the first week a patient is discharged.)
3. Volunteers follow up missed appointments, follow up on transport issues acting as an advocate on behalf of the patient.
Pre-covid, the service was both ward and telephone based. On the ward, volunteers would go through a “Safe, well, warm” checklist with patients about personal safety and immediate needs after they get home, e.g.: food, fuel. Volunteers would run errands for the patients, doing the shopping for them so they would have everything they need when they arrive home.
However, the service was run primarily as a telephone based service where they provided a six week follow up call in which a support plan was developed and implemented. Since covid it has become a fully based telephone service.
They have nine volunteers but would like 20 to manage the current workload. Each volunteer supports four patients as they found this is the maximum number that volunteers can cope with. Each volunteer is asked to commit to three hours per week. There is a high turnover of volunteers as it is an intensive role with high responsibility, resulting in ‘burn out’ for some volunteers. Despite the fact they receive all kinds of support, such as: supervision, support and training, the average time for a volunteer to stay in this role is six months to a year. The volunteering team at Kingston Hospital provides an intensive recruitment & training programme to make sure they get the right volunteers into the role and provide monthly supervision. They also invite guest speakers from the community so that they can bring difficult cases into the group session and share guidance with volunteers on how to help patients.
increase confidence to cope when home from hospital,
increased and sustainable access to community & voluntary sector services.
How they evaluate the service outcomes: by counting the number of organisations that patients are still in contact with after the six-week support plan.
Resources: Team of 6. Details of Laura’s team can be found in the slides.
Scope of service: In the last 12 months - 253 referrals, 210 discharges, active patient list 43 with volunteers working at full capacity.
The team plans to recruit more volunteers in October to increase capacity.
How they promote the service:
The team focused on internal networking and service promotion to generate referrals. So far, far the greatest source is the ward calls made by the team directly. They call the wards twice a week for referrals and often have to explain the service as staff may not be aware of the service.
Other details about the source of referral can be found in the slices as well.
Impact around patient confidence is 20% improvement between the start and end of the support plan.
They monitor which voluntary organisations that patients keep in touch with after the six week call, however, they are not yet able to demonstrate an increase in the organisations that they refer the patients to.
Training: One day which includes active listening skills, generating referrals including types and examples, motivational interviewing to encourage patients to change their behaviours that will benefit their health and wellbeing, techniques for understanding behaviour, confidentiality, My Impact and more. Details of the training can be listened to in the recording.
Use the Helpforce Insight & Impact service evaluation to help analyse the rich data that they have been gathering to help them improve their service.
Reinstate ward visits to generate referrals.
Incorporate travel home, home settling in service
Build up CVS partnerships.
Increase service capacity by increasing volunteer numbers
Speaker: Jamie Goodman from Norfolk and Norwich, Settle in service and community coordinator at Norfolk and Norwich University Hospitals NHS Foundation Trust
The Settle in Service was set up five years ago with the funding that allowed the team to secure a wheelchair accessible vehicle and a dedicated coordinator.
Issue they have had is having a driver and volunteer available when needed. They have now set up a volunteer discharge support service which incorporates all the services.
As they are in a large rural county the area that volunteers travel to has been increased. They have also had to adapt the service because of Covid and now have the national discharge policy to adhere to. The criteria that the setting in service had has changed as there are more complex patients mostly due to the pandemic and the age group of the county. They have had to move the boundary of the type of patients seen so they are constantly working with community partners like British Red Cross and Age UK and growing the service.
The service has been split into two categories:
SILVER: Driver only service where the driver will do the settling in.
GOLD: Driver service, then a settle in volunteer will meet them at the address.
They also offer a 24 hour welfare call service for some patients.
They are growing on a monthly basis. Their plan is to recruit volunteers who have their own vehicles so that they can support more patients.
The full service guide can be downloaded here.
Speakers: Verity Barker – Volunteer Service Manager, and volunteer John Nunn at Royal Cornwall Hospitals NHS Trust
Going Home Bag
This initiative arose from the Covid 19 pandemic review of services which led to a member of staff developing a Discharge Basics pack (nutritional groceries plus toilet rolls) - this was renamed a ‘Going Home Bag' in late 2020- to be provided as a gift to frail, elderly, vulnerable patients at the point of discharge. The wards identified the appropriate patients, and completed a request form, or simply phoned through a request. Funding was generously provided by RCHT Hospital Charity.
A compliment slip is enclosed asking how helpful the pack was but also informing them the Trust would like to hear how patients are getting on and a volunteer would call them in a few days time. They also focus on recruiting experienced volunteers who are home based during the pandemic. Every volunteer has an NHS email account and is provided with patient details. They will then make one call and if necessary signpost them to other local services (e.g.: GP, Volunteer Cornwall). Also, volunteers are now able to provide details of their calls on the Trust’s IT system so that ward staff are aware of what has been discussed.
Volunteer lead receives notes from the wards twice a week and allocates the calls to the volunteers. Unlike other Trusts, volunteers at the Royal Cornwall Hospitals NHS Trusts don’t make home visits. Since November 2020, volunteers donated over 120 hours and made 432 calls. Patients have said that the bags have been very helpful, especially for those who are discharged late at night or in early morning as they have nothing at home.
You can watch the video that describes the service here.
You might also be interested in:
- Crucial role created to provide support to discharged patients
- Role description: Remote discharge support volunteer
- Risk Assessment Form: Discharge Support
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