Attain was commissioned by DGS Health Care Partnership to design and implement a bold new approach to managing hospital demand by shifting care into community settings. Working collaboratively with partners across acute, community, and primary care, Attain supported the development of business cases and early implementation of initiatives to reduce admissions, improve patient flow, and enhance local system resilience – funded from the acute budget.

The programme invested in expanded Hospital at Home, Same Day Emergency Care (SDEC), dementia coordination, and extended home visiting services, targeting frail and complex patients. Within six months, these initiatives delivered measurable impact: reducing emergency admissions, shortening length of stay, and easing winter pressures on the hospital bed base.

What We did

  • Gathered and analysed data - using acute, community, and national data to develop a view of the cohorts of patients creating demand

  • Modelled initiatives and established ROI - aligned the patient cohorts to suggested initiatives to establish which to take forward as having in-year and long-term impact

  • Supported the start of implementation - post-business case approval we set up working groups for initiatives and helped system ramp up implementation

This partnership demonstrates the value of integrated working to deliver sustainable transformation, supporting quality, safety, and patient experience while improving financial sustainability for the system.

Impacts

  • 4,000 fewer bed days (20–25 escalation beds saved)

  • 9% reduction in emergency admissions

This partnership has shown what can be achieved when we invest together in community care. The results are impressive; reducing pressure on beds, improving flow, and supporting our most vulnerable patients closer to home.

Jon Wade, Chief Executive Officer, Dartford and Gravesham NHS Trust