Pathways To Care – a Discharge to Assess service

A single source of truth for the Discharge to Assess Pathway (D2A)

The challenge for Pathways To Care

D2A presents an information-sharing challenge for Local Authorities and NHS Trusts, to ensure the safe, efficient discharge from hospital of vulnerable people, when they’re medically well enough to leave hospital. The process requires a multi-agency approach involving hospitals (ward staff, doctors, discharge teams, pharmacy services), CCGs, adult social care teams, local authorities, transport providers, domiciliary care providers and others.

The updated D2A model introduced in March 2020 aimed to streamline hospital discharges in light of Covid-19. Teams across the country have been using spreadsheets, email and the telephone to exchange information on a daily (sometimes hourly) basis.

The need to solve the D2A challenge and provide a cloud service, supplier agnostic, that would securely digitise this information sharing formed part of the NHS Digital 2020 Social Care Digital Innovation Accelerator (SCDIA) program. The SCDIA focusses on solving problems experienced by Local Authorities, community and primary care, and to develop real working solutions that can be scaled across local government and the wider public sector.


  • Co-production
  • Visual Design
  • User Experience Design
  • Business Analysis
  • Front-End Development
  • Web Development
  • Mobile Development
  • Rapid Prototyping
  • Specification Writing
  • Stakeholder Engagement
  • Workflow Design
  • Responsive Design
  • Technical Architecture
  • Framework Development

Project outcomes

Local Authority and NHS staff have a transparent single source of truth for D2A patients, offering impressive annual net savings.

Maldaba have been excellent to work with on this project. They were highly professional, with a good understanding of the requirements and scope, ensuring all stakeholders views and processes were taken into consideration. This was achieved through Maldaba’s commitment to collaborative working with regular meetings, workshops and communications with all stakeholders.

Jackie Harris, Project Manager, Digital Adult Social Care, NHS Digital

Initial process

Following an open competition, Maldaba was chosen by CC2i (the platform that runs the SCDIA) and the Local Government Association (LGA) as the technical partner to co-produce a solution. Maldaba worked with five Local Authorities and their delivery partners across health, care and transport to co-design and deliver Pathways To Care (P2C), holding online workshops attended by up to 70 staff.

Savings data

Improving discharge arrangements from hospital to home is a complex challenge, involving multiple stakeholders in different parts of the health and care system. Maldaba worked collaboratively and flexibly throughout to support the five co-funding councils and their local health and care partners in developing the Pathways To Care system. Maldaba’s adaptability, clear communication and understanding of user needs and pressures were all critical to making rapid progress amid changing hospital discharge guidance and the pandemic. Their ability and commitment to deliver a viable product meeting the diverse needs of multiple localities in these circumstances was impressive.

Edmund Willis, Care and Health Improvement Programme, Local Government Association

Core features

P2C offers case management, tracking and reporting features, allowing users from multiple organisations to create, update and monitor D2A cases across multiple pathways on an open, human driven platform. P2C supports the D2A process from the point at which a person is identified on the ward as requiring support on discharge, through to the point that the person receives an assessment on their longer term needs within a community setting.

Pathways To Care screens

Our experience has been one of real collaboration throughout the project, design through to development and implementation, which included work in relation to information governance and cyber security. Maldaba were keen to ensure that the technical system delivered what we needed to support and transform the way we worked across health and social care, regular meetings were held to ensure there was a good understanding of the issues we faced and how the digital solution could help. They have flexed and adapted the digital solution as issues or staff suggestions for additional functionality came up. Throughout the project Maldaba actively ensured we were engaged, listened and acted on our feedback and delivered against expectations, delivering a product that staff are using, and think is a fabulous solution that has transformed the way they work. Maldaba have been a real pleasure to work with in a truly collaborative way.

Wendy Lawtey, Head of Adult Social Care & Performance, North Lincolnshire Council

Related case study – PAR

Maldaba have collaborated with the Training and Research Support Centre (TARSC) to create a web-based digital platform for the Participatory Action Research (PAR) process.

PAR spiral

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We work closely with NHS and healthcare operations leaders to develop innovative and user-friendly software solutions designed to solve complex problems, make processes more efficient and, ultimately, deliver long-term improvements to patient experience and the wellbeing of healthcare workers.

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