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"All I wanted was to be at home" – Short Term Intervention Team success

Pat, smiling with her arms raised slightly at her sides sitting on her sofa
Sheffield resident, Pat.

The story of a loved one who just wants to be back home where they belong, instead of in a hospital bed, is a familiar one to all of us.

Everyone wants the comfort and safety of their own environment after a stay in hospital and a safe and timely transition home relies on the work and support of professionals, and family and friends.

Sheffield City Council’s dedicated Short Term Intervention Team makes the transition out of hospital for people returning home as smooth as possible. The service helps those recently discharged from hospital with doing the things in the home that they did before to continue living that life they want to live. It now helps 95% of people with support in the home at the point of discharge, with the other 5% of people being discharged into nursing or care home setting.

What the Council does at this time links in closely with the Therapies team in hospital, which focuses on helping people become stronger and more physically well. This can include physiotherapy, occupational therapy and providing the right equipment and adaptations.  

The aim of the Short Term Intervention Team is to make discharge personal, where individuals and their families have good experiences during their stay in hospital, as well as experiencing a positive, safe, and timely discharge, which they are involved in planning with the service.

The approach centres around the principle of ‘home first’ and optimising on-going care and support through timely out-of-hospital assessment. It gives people the help they need to recover and to regain their independence, to get on their feet and stay on their feet, and regain the confidence they need to live their life independently for as long as possible.

Sheffield now has above average figures nationally for keeping people at home instead of them being re-admitted to hospital when what they need is support in the home.

Of the total number of people discharged from hospital who require home support, 48% of them are now receiving a service within 48 hours of their discharge date.

In addition, Home Care provider waits have reduced from 151 in December 2022 to 18 in March 2023.

This big change has all been possible by working together with the National Health Service and designing services that meet the needs of patients and their families. The joint working has resulted in helping 2,569 people since June last year to return home after a hospital stay, by providing ‘the right care at the right time’.

When Sheffield resident, Pat, left hospital, the Council’s Short Term Intervention Team worked with her to make sure that she had everything she needed. Pat talks with her daughter and Councillor Angela Argenzio in the video below about the practical changes she has been able to make supported by the service.

The team expects to support over 5,000 people to be discharged home in 2024, helping more and more people regain their independence and reduce their need for ongoing care and support.

Councillor Angela Argenzio, Chair of the Adult Health and Social Care Committee at Sheffield City Council, said: “It was interesting listening to Pat’s perspective and reassuring that the service is seen as a positive intervention and that it works in helping people to make a full recovery.

“It’s all about reducing, preventing, and delaying need so that people can live well and confidently at home. Staying in hospital for longer than needed often means that people lose more independence than they would like, so this work is so important to so many people.  The team working between the hospital discharge team, the patient and those providing assessment and specific expertise is proving to be an effective way of helping people recover their much-needed independence.”

Notes for editors:

  • The overarching Adult Health and Social Care vision is for every adult in Sheffield to be able to age well and live the life they want to live, with choice and control over the decisions that affect them.
  • This has been supported by the additional home care hours funded by the Better Care Fund discussed at Sheffield City Council’s Adult Health and Social Care Committee in June 2023, remodelling, and building capacity as well as engagement with its providers.