Adult Social Care Glossary, v 0.6

Pathways for the discharge to assess model

(Adapted from John Bolton model for persons aged 65 and over, and when used across all 18+ age groups, it is expected that a greater percentage than detailed will be allocated to pathways 0 and 1.)

Pathway 0 (likely to be minimum of 50% of people discharged): simple discharge home

- no new or additional support is required to get the person home or such support constitutes only:
- informal input from support agencies
- a continuation of an existing health or social care support package that remained active while the person was in hospital

Pathway 1 (likely to be minimum of 45% of people discharged): able to return home with new, additional or a restarted package of support from health and/or social care. This includes people requiring intensive support or 24-hour care at home.

- Every effort should be made to follow home first principles, allowing people to recover, reable, rehabilitate or die in their own home.

Pathway 2 (likely to be maximum of 4% of people discharged): recovery, rehabilitation, assessment, care planning or short-term intensive support in a 24-hour bed-based setting, before returning home.

Pathway 3 (for people who require bed-based 24-hour care): includes people discharged to a care home for the first time (likely to be a maximum of 1% of people discharged) plus existing care home residents returning to their care setting (for national data monitoring purposes, returning care home residents will count towards the 50% figure for pathway 0).

Those discharged to a care home for the first time will have such complex needs that they are likely to require 24-hour bedded care on an ongoing basis following an assessment of their long-term care needs.