Project AMM41

Exploring older people's experiences of returning home from hospital on the Discharge to Assess pathway: implications for social care practice

A qualitative study using interviews to explore older people's experiences of receiving support from social services, after returning home from hospital on the Discharge to Assess pathway.


Achieving quicker discharges has become a national policy priority, due to pressure on NHS resources, the demands of an expanding population, and evidence that remaining in hospital unnecessarily causes health decline to accelerate (DHSC, 2022). This has led to a change in role for social care practitioners, in which care assessments (also known as “Care Act assessments”) take place after discharge, in people’s homes. As well as this resulting in reduced numbers of practitioners based in acute hospitals, changing demographics mean the number of older people needing support is expected to rise. This makes it vital to learn from their views and perspectives, as a means of learning more about the social care role in this context and how it can be used to achieve better quality outcomes.

Project Aims

The aims for this study are: 

  • To gain a deeper understanding of how post-discharge assessment is experienced by older people in Norfolk and Hertfordshire
  • To identify factors in social care practice that can promote older people’s social and emotional needs, and physical or functional wellbeing, after discharge from hospital
  • To identify the systemic factors that affect the delivery of social care practice concerning hospital discharge
  • To generate new ideas for models or interventions that could be used to support social care practice concerning hospital discharge

Project Activity

This project will involve:

  • Semi-structured interviews with older people who have left hospital and been assessed / supported by a social services professional at home
  • A ‘Community of Practice’ approach will be used to undertake the research, consisting of professionals and Experts by Experience who have an interest in the topic area. Expert experience will help to shape the interview questions, make sense of the findings and generate outputs which can be used to inform future practice

Who is involved?

  • Principle Investigator: Toby Connell, Research in Practice Lead (SCRiPT Study, East of England Research Partnership)
  • University of Hertfordshire
  • Associate researchers from Norfolk County Council and and Hertfordshire County Council


Toby Connell,

This project is part of the SCRiPT study, click here to read more about SCRiPT