Shorter stays will benefit patients who would otherwise be stuck in hospital when they are well enough to leave as well as freeing up beds for those who are sicker.
Many older people, particularly those who are frail and may have dementia, actually deteriorate while in hospital – a stay of more than 10 days leads to 10 years’ muscle ageing for people most at risk.
Nearly 350,000 patients spend more than three weeks in a hospital each year. That is around a fifth of beds, or the equivalent of 36 hospitals. Some patients need to be there for medical reasons but many do not.
The NHS, working with local authorities, aims to reduce the number of long staying patients by around a quarter, freeing up more than 4,000 beds in time for the winter surge.
Simon Stevens said:
“Over this past year hospitals and local councils have successfully worked together and have turned the corner on delays in patients being discharged. Now they need to go further in order to ensure patients are treated with dignity and looked after in the right setting for them.”
The joint announcement comes as the NHS is drawing up plans for next winter after having been hit by a perfect storm of bad weather, flu and stomach bugs, along with record A&E attendances and emergency admissions, in the winter just gone.
NHS Improvement’s Chief Executive, Ian Dalton, will say that his organisation and NHS England are determined to tackle the issue of bed availability before the onset of next winter, with a message going out to the system including chief executives of acute trusts, CCGs and the chairs of health and wellbeing boards, calling for them to act now.
Ian Dalton said:
“No one wants patients to stay in hospital longer than they have to, or for the health of patients to deteriorate in the very place that is supposed to be making them better. But this is happening all too often and we have to work together to change it. Every day in hospital is a precious day away from normal life.
“By setting this national ambition and working with trusts and local systems to deliver it, we will help more patients to recover safely and as quickly as possible, while ensuring that hospital resources are used for those who need them most.“
Rachel Power, chief executive of the Patients Association, said
“Meeting the needs of older people who have complex combinations of long term conditions is a key challenge facing the NHS. Prolonged stays in hospital are often not the right solution for these patients. Improved support to ensure patients can stay as well as possible in their own homes, whether immediately after an admission or as a way to prevent one, will be vital in ensuring the NHS meets the changing needs of our population.”
Sally Copley, Director of Policy and Campaigns at Alzheimer’s Society, said:
“For too long people with dementia have been pulled from pillar to post in our not-fit-for-purpose health and social care system. It’s great to see the Government sitting up and taking this issue seriously with an integrated approach, and more support for care home staff is definitely welcome.”
The new drive aims to build on the success of the NHS and local councils in tackling delayed transfers of care (DTOCs). The number of DTOCs fell to 4,880 in January, 1,780 fewer than the baseline month of February 2017.
To meet the ambition NHS trusts will be expected to close the gap between the number of patients discharged during the week and those sent home at the weekend and make greater use will be made of alternatives to admission such as emergency day cases or therapy services.
Hospital stays above the best practice guidelines will be treated as a safety issue that urgently needs addressing with the time patients have spent on wards closely monitored through the Patient Administration System.
Trust will be supported by extended GP access and a focus on avoiding unnecessary hospital admissions including more support for care home staff to prevent residents being admitted. There will also be regional emergency care intensive support teams charged with helping to deliver the 25% ambition.