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Charity’s Vital Hospital Discharge Service renewed

Published on 06 February 2024 01:57 PM

Since Spring 2022, Age UK Plymouth’s new Hospital Discharge Service has supported more than 800 older people following long term hospital stays.

In a testament to the success of the Hospital Discharge Service, Age UK Plymouth have had their contract renewed by NHS Devon in a move that will enable the charity to provide four week care packages to over 600 people returning home from hospital.

“This is wonderful news for the community we support,” said Age UK Plymouth CEO David Wood. “As one of our newest functions, the Hospital Discharge Service is a fantastic example of how we as a charity are dedicated to innovation to answer the needs of the community. We created this resource as a reaction to the pressures on the NHS locally, and specifically in support of University Hospital Derriford, Mount Gould Hospital and various seasonal care hotels.”

Age UK Plymouth’s fully trained and experienced team delivers a safe and caring service that understands not only the impact to physical and mental health but also the disruption a long term hospital stay can cause to an person’s life and home. As individual as the clients the charity supports, these four week packages of care can include a wide variety of help from domestic chores, deep cleans, support with correspondence and admin to prescription collections and assisted trips to build confidence or attend appointments. The Hospital Discharge Service also have access to their own Gardening and Handyperson team who can support in some adaptations to the home that may be required following a clients rehabilitation, also a range of gardening and basic home maintenance that may be needed after a long spell away from the home in hospital or respite care.

The team can often find themselves supporting clients whose homes have become unmanageable for them. A patients’ discharge progress can often be disrupted if there are concerns around their safety at home, the team can mobilise within 72 hours to tidy and deep clean properties and allow discharge to go ahead.

 “Each package of care delivered is carefully tailored and utilises the full range of services available to clients through Age UK Plymouth,” explains Mandy Grant, Senior Discharge Support Coordinator at Age UK Plymouth. “We’re completely client focused, once the referral has been received every package starts with a member of the team meeting and greeting the patient while they are still in hospital. On the day of discharge or shortly afterwards, the team will then visit the patient in their own home and delivery of the package will commence. In this way we can make sure that each patient has a dedicated support throughout their transition from hospital to home. This is such a crucial point in their discharge journey when, if unsupported, the patient can be most at risk from re-admittance to hospital, a failed discharge.”

In it’s first 18 months the Hospital Discharge Service has supported over 830 patients, more than 350 have been referred through to the charity’s Information and Advice Team and have been able to maximise income through benefits checks and claims for Attendance Allowance. A third of clients pathway transition into Discharge’s sister team Help at Home, who provide ongoing support to help people remain living independently in their homes for as long as they wish to do so. Around 400 clients have been signposted to Devon and Somerset Fire Service for a free home fire safety check and this winter at least 50 clients will be supported with a Home Energy Check from Age UK Plymouth, helping reduce fuel poverty in one of the UK’s most deprived areas.

“If our service wasn’t there, and patients were discharged from hospital with no family support, no additional support around them and no hospital to home provision, their outlook and their recovery would be very much impeded,” said Sarah Hopes, Head of Community Support at Age UK Plymouth. “There would be no support elsewhere and not only would there be no support elsewhere, they wouldn’t know where to look for that support.”

Putting life back together after a long term hospital stay can be a daunting task, but Rapid Responders support by making it possible for clients to attend appointements, collect prescriptions and even kit themselves out with new clothes and shoes.

In a classic example of how Age UK Plymouth’s various services are woven together to create bespoke packages of care, one gentleman was referred to the service as a frequent user of the Emergency Department. “It was felt that the client’s anxiety was the primary reason for the high volume of calls to the Emergency Services,” explains Tracy Walker, Head of Day Centres who visited the client in his home to understand the challenges he was facing and how Age UK Plymouth could create a network of support for him. “We worked steadily on building a relationship with the client that reassured him that the charity could help him tackle his feelings of isolation and loneliness, equipping him with the emotional resources needed to reduce and ultimately remove the reliance formed on the Emergency Services.”

During his four week package of care, this client was also referred to the charity’s Information and Advice team who were able to identify entitlements that the gentleman was able to use towards maintaining support after his package of care finished. He now attends Age UK Plymouth’s day centre three times a week, collected and dropped off home by staff from the charity, is able to utilise a showering service to improve his self-care and enjoys hot meals at the centre. “This establishment has excellent staff, I definitely recommend it and everyone is so welcoming,” he said. “Accessing this service has increased my wellbeing 1000 times, the best thing that’s ever happened to me!”             

The continuation of the service and allocation of funding for an additional 600 people over the next 12 months will be a lifeline to many facing the journey to rehabilitation alone. “I cannot fault anything about the service I received from the initial contact through to the wonderful responder who supported me. Just knowing that someone was coming to see me helped me mentally,” said one client. “After 3 months in Hospital I came home and didn’t know if I was coming or going,” said another client. “The ladies helped me so much with making appointments and getting to and from the doctors. They sorted things out for me.”

For more information about any of the work of Age UK Plymouth, please visit To find out more about working in partnership with Age UK Plymouth or to talk about how your group or organisation can work with or support the charity please email

“Feels like someone cares about me which helped my confidence so much”.

“My responder helped me prepare meals and helped around the house. I didn’t know this service existed and I am so grateful the hospital referred me over”.

“Very helpful, amazing service. My responder was such a big help to me, we had lots of laughter on her visits too! As I have poor mobility and breathing difficulties it really has been fabulous to have this additional support, I will miss her greatly”.

“Every single member of staff is so helpful and lovely. In every way it has been so helpful. When I came out of hospital I was in so much pain, with 48hrs AUKP had arranged for an OT visit and a hospital bed was delivered the next day. It has helped my physical and mental health and I can’t thank you all enough!”

“Amazing! It’s just been a wonderful service”.