Discharge to Assess (D2A)

At Valorum Care Home, we understand that transitions from hospital to a place of continued care can be a pivotal moment in one’s journey to recovery. That’s why we offer a unique and compassionate approach through our Discharge to Assess (D2A) pathway, designed to ensure a smooth transition for person who may not be ready to return to their previous place of residence after hospitalisation.

What is the D2A Nursing Home Pathway?

The D2A pathway recognises that some patients may be medically ready to leave the hospital but require additional support and assessment before returning to their usual living environment. In these cases, individuals are discharged to a nursing home, like Valorum Care Home, where they receive specialised care and ongoing evaluation to facilitate their recovery.

Why Choose D2A?

Staying in the hospital longer than necessary can decrease strength and mobility and increase the risk of infections. The D2A pathway offers a more conducive environment for recovery outside the hospital setting, ensuring individuals receive the support they need to regain their independence and well-being.

Ongoing Support and Communication

We recognise that the discharge process can be challenging for individuals and their families. That’s why our team is committed to providing ongoing support and open communication throughout your transition and beyond. Whether you have questions, concerns or need reassurance, we’re here to help every step of the way.

Why is D2A Used by Hospitals?

Amidst the ongoing pressures the NHS faces, the utilisation of Discharge to Assess (D2A) has become imperative. Hospitals now experience high occupancy levels during winter and the summer months, leading to stretched capacity and a shortage of beds. D2A serves as a valuable pathway for hospitals in managing patient flow effectively and preventing bed blocking.

Who Pays for D2A?

Funding for the D2A pathway is provided by the local authority through government allocations. It encompasses either full funding or a mutually agreed funding level with the care provider, with no repayment obligation imposed on the patient. Although the D2A pathway officially spans 4-6 weeks, instances of extended durations are not uncommon. In such cases, the local authority continues covering the care fees without any repayment obligation from the patient.

What Happens After the Initial Period?

Upon concluding the D2A pathway, an assessment is conducted by a Social Worker to determine long-term funding arrangements. Three potential outcomes emerge from this assessment:

• Full funding via NHS Continuing Health Care (CHC).
• Self-funding by the patient.
• Funding provided by the local authority.

Considering long-term funding implications early in the process is vital to avoid subsequent moves, as transitioning from a hospital to a care home can be challenging for patients.

Can Patients Choose Their Preferred Care Home?

One limitation of the D2A pathway is the limited choice available to patients. Hospital discharge teams typically facilitate discharge to various care homes listed via email, with cost often dictating the selection. Families may not always secure their preferred care home or may need to travel further than desired due to this constraint.

However, there are instances where families regain some control over the process:

• Availability of beds in the chosen home despite a shortage in the area.
• Strong justification for prioritising a specific care home, though rare.

While families can bypass the D2A pathway through self-funding in their chosen care home, it’s a decision not to be taken lightly, given the significant cost-saving benefits associated with D2A for the patient.