(Pathway 1)
Discharge to Assess (you might also hear it called D2A) is a community service that helps people leave hospital sooner. We do that by carrying out any assessments you need at home rather than you having to wait in a hospital bed for them to be carried out.
Our aim is to ensure you can live at home (or in your place of residence) independently with the right support that you need to do that. Our service carries out the assessments that allow that to happen in your own home. This is better than having the assessments in hospital on a ward as it allows us to work with you in your own home where we can see how you live day to day. It also means you can come home from hospital sooner with the right support around you.
We help anyone over the age of 18, who has given us their consent. They must live in Trafford or have a Trafford GP. The hospital discharge team will refer you to us. Referrals are not limited to specific conditions.
We are a multidisciplinary team of highly skilled staff from health and social care and will arrange to visit you at home as soon as you are discharged. In many cases we will try and come to visit you on the day you come home from hospital if you are home in time.
We will contact you by phone and arrange to visit you at home to complete your comprehensive assessments.
The team will carry out a range of assessments depending on your needs. This might include:
- Nurses to assess your medical and health needs when leaving hospital and refer you onto other community services for any ongoing support that you need
- Occupational therapists to assess and recommend equipment for you to increase your independence in daily living activities
- Physiotherapists to assess provide you with home exercises to improve your strength and mobility
- Pharmacists and technicians to assess your medication needs and liaise with your GP if any new medication is needed
- Senior support workers who can practise any exercises with you and show you how to use equipment that is provided.
We can support you for up to seven days whilst assessments take place. If you need ongoing support after seven days we will, with your agreement, arrange referrals to other community services or agencies that can support you at home. We will also write to your GP to let them know about the care you have received from us and what we have agreed.
Our service is available from 8am to 6pm, seven days a week and 365 days of the year. If you are being cared for by the team and have any questions, you can contact us via:
Tel: 0161 549 6930/6931
If you are calling outside of our service hours for non-emergency advice please contact NHS 111 or your GP Surgery in the first instance. In case of an emergency please contact 111 or 999 for immediate advice or support.
If you need to write to us at all, our team is based at:
Meadway Health Centre,
Sale
M33 4PS
This service is being introduced to support timely assessments for patients requiring therapy at home on discharge.
The service is 7 days a week, 365 days per year, 8am – 6pm. Initially we will only be taking discharges Monday to Friday until the workforce is fully recruited to.
Referrals are via Hospital Discharge/Therapy Teams. The referrer must complete the GMSD referral form with relevant information outlining the therapy requirements together with their therapy goals in order to support the community team to identify and plan appropriate input.
When completing the GMSD form please indicate the pathway that is required:
- Pathway 0 – able to return home with no health or care needs, but who may benefit from signposting/information delivered by the community care navigators
- Pathway 1 – able to return home but needing support from health/social care services.
The completed GMSD form must be sent to the team via email to: TraffordCommunityResponse.DTAP1@mft.nhs.uk
Enquiries to the team can be made via 0161 549 6930/6931
Reminder of Hospital Discharge Pathways [PDF, 184KB]