An Integrated Discharge Planning Pathway Between Acute and Social Care Services is Needed to Prevent Delay in Care Transfer for Babies with Safeguarding Concerns

Background: Discharge pathway for babies with safeguarding concerns in neonatal unit encompasses close working relationship between acute and social care services. Yet, there is increasing pressure on both services in regards to patient flow which compromise this partnership hence patient care.

Objectives: To facilitate neonatal discharges with safeguarding concerns by counting and collecting data about delayed transfer of care from acute setting to social care services.

Methods: A retrospective survey was conveyed on all neonatal admissions with safeguarding concerns over a period of 12 months (2017-2018) at our neonatal unit at University Hospital Lewisham. A total of 21 babies were admitted at neonatal unit during this period. Data were collected from their case notes about the safeguarding and medical history and management. Also, the gap between the dates when they were medically fit for discharge versus when they were safe to be discharged was analysed including the reasons behind delay for discharge.

Results: There was a total of 210 days over the period of 1 year when babies were medically fit for discharge but not fit for discharge due to awaiting discharge planning meeting, court hearing and housing issues. Of note the delay in discharge was longer in babies who were discharged home compared discharged to foster carer. There was only 1 baby with no gap between medically fit and being safe discharge date.

Conclusion: Discharge planning pathway for safeguarding cases should be in parallel with medical management rather than being sequential. There is a need to develop a robust and consistent guideline to integrate discharge pathway from acute care to social care services from the very first day of admission of babies with safeguarding concerns.