LGA 25 Case Study Bundle

A new HomeFirst model of intermediate care in Leeds

The HomeFirst programme Leeds Health and Care Partnership, which brings together health and care organisations in the city set out to transform the way that intermediate care is delivered. The HomeFirst programme was developed to achieve a person-centred, home-first model of intermediate care that is joined up and promotes independence. By working together in a true partnership, system partners have delivered a new model of intermediate care within existing workforce, funding, and organisational arrangements. Fundamental to the success of the HomeFirst programme has been building on the culture and relationships across partners in the system, embedding a culture of collaborative decision making and service delivery. The HomeFirst programme consisted of five interrelated projects which focued on maximising independence and ensuring that residents always achieve their best outcome.

The five projects were: ƒ Active Recovery at Home: redesigning the home-based intermediate care offer to maximise capacity and deliver the best outcomes for people accessing these services. ƒ Enhanced Care at Home: transforming preventive services to avoid escalations in need with a specific focus on avoidable acute hospital admissions. ƒ Rehab and Recovery Beds: transforming bed-based intermediate care to improve outcomes and minimise length of stay in short-term beds. ƒ System Visibility and Active Leadership: making use of the wealth of data in the system to produce system and service level dashboards, while establishing the right cross-partner governance to use these for effective decision-making. ƒ Transfers of Care: redesigning the discharge model to minimise discharge delays and ensure the system achieves the most independent outcomes for people leaving hospital. The new ways of working have been designed, trialled, iterated and scaled by experts including frontline staff and operational managers from across the system.

The beauty of HomeFirst is that it has brought people together through a partnership and TeamLeeds approach to look at all the key transitional points where people move from the community to hospital, from hospital to home, and from hospital to community care beds. It feels so much more joined-up now because we have had so much commitment to doing this as a system rather than individual organisations. Sam Prince, Executive Director of Operations, Leeds Community Healthcare NHS Trust

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