ARU works with UCAN to evaluate Ticket Home pilot initiative

A doctor talking to an elderly man while entering information into a tablet device

When community-based charity Uttlesford Community Action Network (UCAN) looked to roll out their Ticket Home model beyond Princess Alexandra Hospital, where they were running a pilot initiative, they asked ARU for an independent academic evaluation of the trial.

UCAN developed the Ticket Home pilot initiative in 2022 to address the strain on hospital bed availability and improve the patient discharge experience in light of increasing demand for in-patient services and shortages of medical personnel in NHS acute hospitals.

To get buy-in to deploy the model in other West Essex acute hospitals, including Whipps Cross Hospital, Broomfield Hospital, and Addenbrookes Hospital, UCAN needed to demonstrate the pilot's success. ARU academics Dr Oonagh Corrigan and Dr Pamela Knight-Davidson therefore worked with Clive Emmett and his colleagues at UCAN to define the scope of the evaluation and deliver a report to inform the initiative's future.

A safe route home

The Ticket Home model aimed to address concerns about the negative impact of extended hospital visits on the health of the elderly, as research has indicated that this can lead to a decline in long-term health, or even death.

Delayed discharges are also financially costly for the NHS, with reports showing that the monetary expenses of such delayed discharges between 2022 and 2023 are estimated to be around £1.7 billion. Therefore, once hospital treatment is completed, it is critical to ensure patients are discharged safely and on time.

The Ticket Home model emphasises supporting people to be discharged safely when clinically ready, with timely and appropriate recovery support, and assessing longer-term or end-of-life care needs.

A spirit of collaboration

Oonagh and Pamela collaborated closely with the UCAN Ticket Home team during the evaluation, conducting informal interviews with healthcare professionals to learn about their work experiences and identify any issues they encountered, observing participants to determine the model's effectiveness, and collecting data from an online portal used to update patient discharge status and track activities undertaken to support patients.

Participants could discuss the operational aspects of the Ticket Home intervention and meet with Oonagh and Pamela to provide feedback on the researchers' findings.

This collaborative approach ensured ongoing engagement between evaluators and programme staff, making everyone feel included and part of the process. Such an approach is believed to lead to stronger evaluation designs and improved outcomes that stakeholders can understand and apply.

The evaluation resulted in a detailed report co-produced by UCAN staff and ARU social scientists. It presents a summary analysis of the challenges of discharging patients from hospitals and evaluates UCAN's support in this area.

Oonagh and Pamela's comprehensive analysis of challenges in safe and timely patient discharge and evaluation of the initiative, combined with their collaborative approach, meant UCAN could be confident that the evaluation was thoroughly and effectively conducted.

"The most enjoyable part of this experience is the collaboration and joint working we had with the academics that contributed to a comprehensive report, we all felt part of the compilation."
Clive Emmett
UCAN