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Patients being helped to stay well after leaving hospital

Published 20/06/2013

Patients preparing to leave hospital in Derby are taking part in a pioneering new scheme which gives them support to help them stay well once they get home.

The Royal Derby Hospital is using the enhanced discharge scheme for patients who are at high risk of readmission, to give them the confidence and independence to manage their condition at home and reduce unnecessary hospital readmissions.

The Enhanced Discharge Support Programme is run with support from local GPs, community staff and social services and offers patients who are suffering from some lung conditions and heart problems additional help and support whilst they are still in hospital to avoid an unnecessary readmission. The programme is running on four wards at the Royal Derby Hospital and so far 288 patients have been through the programme, with only 38 patients being readmitted within 30 days of discharge.

A few days before they are due to go home, the patient is seen by an enhanced discharge nurse to talk in detail about their medical condition, go through the medication prescribed, give advice on how to keep themselves well and the signs to be aware of to avoid their condition deteriorating. On the actual day of discharge a verbal hand over is given by the nurse to the community team to ensure that they are fully aware of the patient’s specific needs. At home the patient then receives a phone call from the nurse to see how they are and if they have any concerns which they need to talk about.

Samantha Reed, enhanced discharge project nurse said: “By giving the patient a greater understanding of their medical condition and the support they need when they leave hospital, we hope this will give them more confidence so they can manage their condition and keep out of hospital.”

One patient who has benefited from the discharge programme is heart patient Andrew Baldwin from Etwall. He said: “When I had a heart attack back in 2003, I received a very brief talk on the day of discharge and my wife and I were shown a video about what life would be like following a heart attack. This time it has been completely different, and I feel so reassured. No one had ever explained my medication before and I now know the things I need to focus on, such as changes to my diet and ways to slow myself down. It has been a real benefit and is very assuring.”

This project has been shortlisted in the Health Service Journal Efficiency Awards, which will be announced in September 2013.


For further information, please contact:

Liz Smith

Communications Officer

Derby Hospitals NHS Foundation Trust 


01332 785778

Last Modified 20/06/2013