​​​Hospital Transfer Pathway (Red Bag)​

The Hospital Transfer Pathway, affectionately known as the 'red bag' scheme was designed to ensure that residents living in Sutton care homes receive safe, coordinated and efficient care should they need to go into hospital in an emergency.

The pathway is a link that supports care homes, the ambulance service and the local hospital to meet the requirements of the NICE guidance on transition between inpatient hospital setting and care homes.

The initiative was developed in response to discussions with key partners involved in care home resident's circle of care, where gaps were identified in providing the necessary support and care to unwell residents that needed to go into hospital.  Residents were being taken to hospital without the necessary clinical information and subsequently discharged without a summary of the care they'd received whilst admitted.  Poor communication channels made it difficult for care staff to talk to each other, resulting in residents often remaining in hospital for longer than they needed to.


Principles of the Hospital Transfer Pathway

  • Every resident has a red bag that contains their personal information documents, their medications and their belongings and clothes for travelling home in
  • Every point of contact in the resident's journey from care home to hospital knows their personal information (who they are, what their health and social care needs are when they are well, and what their wishes and preferences are).
  • Every person who meets the resident knows what the reasons are for them going into hospital
  • Every care home manager or nominated deputy is available to support the resident whilst in the hospital, visits within 48-72 hours of admission and is involved in the episode of care
  • Every resident, or if they don't have capacity, their lasting power of attorney or a best interest decision, consents to their personal information being shared between the care home, the hospital and the ambulance service
  • Every relevant hospital and ambulance service staff communicate all relevant information about the resident with each other and with the care home

The greatest impact of this pathway has been on the quality of care provided to the resident. All clinical information is available for the resident to receive safe, coordinated and efficient care, and personal wellbeing information enables staff to provide more person-centred care. There is a significant improvement in relationships and the channels of communication between care home staff and local hospitals.

An initial review of the scheme has also showed significant savings and clinical improvements such as reduced length of stay, fewer personal belongings being lost, reduced poly-pharmacy, and a decrease in the use of A&E, hospital and ambulance services.

A more thorough evaluation was undertaken in December 2017 as part of the wider programme evaluation.

Evaluation of Sutton Vanguard Interim Report December 2017

Find the standardised paperwork and other resources on the resources page of the website.

Watch this short film for an overview of the pathway:

 


Watch the pathway in practice in this short film, and meet the leads from care homes, ambulance and hospital that have experienced the benefits of the pathway: 

 


This film is used as a training video on induction for all staff at St Helier Hospital.

Read this complete Implementation Guide if you are interested in implementing the Hospital Transfer Pathway in your area.

Hear from a care home resident about her experience and the importance of the pathway to her:

 


Read this case study.

Watch this short film developed by the New Care Model team:

 


Through a series of interviews with staff, residents and volunteers, the film showcases the impact NHS New Models of Care are having on people's health The focus from the Sutton Vanguard here is on the red bag and impact it has had on care for residents.


The Hospital Transfer Pathway in Learning Disability Care Homes


Based on the success of the pathway for older people's care homes, it was then adapted for people with learning disabilities that need to go to hospital.

The pathway was piloted in 11 Learning Disability homes from April 2017 for eight months, and then rolled out to all Learning Disability Care Homes in Sutton in November 2017.

The steps in the pathway and principles remain the same, however the paperwork has been adapted.

Find the standardised paperwork on the resources page of the website.