What does D2RA stand for?

D2RA stands for Discharge To Recover and Assess, which is also known as the patient pathways zero to three. The patient definitions for these pathways can be found below.

Pathway 0

No additional support required for discharge.

• Fully independent - no further support required.
• Multidisciplinary team assessment within hospital front door units to avoid full admission.
• Patient returns to usual place of residence, including care home.
• Restart package of care (POC) with no changes.
• Has pre-existing community services in place.

Pathway 1

Supported Home First - Go to this page to find out more about the integrated Home First service, including how to make a referral.

• Patient returns to usual place of residency with short-term support.
• Preventative services delivered in collaboration with third and voluntary sector organisations e.g. meal provision, shopping and housing.
• New package of care (POC) or increase of existing package.
• Short-term reablement to maximise independence.
• Assessment and some additional care and support (including therapy, nursing, pharmacy, domiciliary care and new equipment e.g. community resource teams).
• Safe between calls/overnight.

Pathway 2

Short-term supported facility.

• Patient is transferred to a non-acute bed and receives rehabilitation/reablement and assessment until able to return safely home.
• Unsafe to be at home overnight/between care calls.
• Currently needing some care (e.g. ADL) support/intervention 24/7.
• Includes specialist rehab (e.g. stroke, neuro and trauma and orthopaedic).

Pathway 3

Complex support.

• Patient is transferred to a new long-term bed, assessment bed or usual residence and receives the complex support and/or assessment for their needs.
• Complex/significant health and/or social needs in usual residency.
• Significant change requiring new placement.
• Longer-term placement.
• Life-changing health care needs.
• Complex end of life or mental health needs.