Hearing the views of patients, families and staff on pilot rehabilitation scheme

The survey was carried out in October 2022 involving face to face interviews with patients and staff at Little Manor Care Centre, Salisbury. Families and carers were also invited to give their views by completing a questionnaire.

We also interviewed care staff, nursing staff, social care workers and therapists as well as the Quality Assurance and Placement Manager.

This project was carried out at the request of Wiltshire Council. 

What is Pathway 2?

Pathway 2 is a term used by the NHS to describe the type of “pathway” or process for discharging patients from hospital who are medically ready but need some extra help in a care setting before being able to return home (ie, where they lived before their hospital admission). 

The pilot Pathway 2 model involves a multidisciplinary team of therapists, social care workers and care/nursing staff being based together on one site. 

The aim is to speed up patients’ recovery away from a hospital environment and build their confidence and independence so that they are ready to move on after 28 days. Patients are supported to achieve their goals and receive a social care assessment alongside their rehabilitation programme. 

What were the key findings?

• Most patients had not been prepared by the hospital for their arrival at Little Manor. They had no understanding of their destination, the reason they were there, or how long they would be there. Many were distressed and confused and it took considerable time for them to be reassured.
• Patients felt involved and supported in their rehabilitation and appreciated the staff and care setting.
• Key to the model’s success is accepting patients who meet the Pathway 2 criteria as they are able to take full advantage of the therapy provided, make a more rapid recovery and leave within 28 days.
• Brokerage teams (who find care home beds for people who are ready to leave hospital) need to better understand the importance of patients correctly meeting the eligibility criteria and the capacity of Little Manor.
• Most staff felt that Pathway 2 was a different way of working but were comfortable with this and felt that the multidisciplinary approach improved outcomes for Pathway 2 patients.
• A multidisciplinary team working together on one site makes a huge difference; saving time, enabling a more informed picture of the patient and their needs and a better service.
• Having social workers on site helps to identify the care packages patients’ needs much earlier, reducing delays to the patient’s return home.
• Experience of the Pathway 2 pilot has been positive to date.

Conclusions and recommendations

Overall, patients, staff and the families and carers who gave their views were very positive about the benefits of the Pathway 2 pilot model being trialled at Little Manor. But improvements could be made around referrals and better information is needed for patients on their discharge from hospital and for them to understand why they have been sent to a care home for rehabilitation.

We have made a number of recommendations based on the feedback we heard.