Delays in discharging people who have had their medical condition stabilised to out of hospital after treatment is at its highest level in five years, since records began. A government commissioned report on the NHS by Labour Peer Lord Carter said that information provided by trusts estimates that as many as 8,500 patients a day may be affected (while official statistics have suggested 5,5000) Lord Carter said this delayed transfer – so called “bed blocking” – costs the NHS £900 million a year.
It is a year-round problem, but it becomes more acute in the winter months. A very high proportion of these patients are older people. Delayed transfer means hospitals are unable to admit new patients and so causes delays in scheduled interventions.
The 24-7 rapid response assessment and admission service, which is operated by Four Seasons Health Care, helps hospital discharge teams, CCGs and social workers to locate care services in appropriate nursing, dementia care and residential care homes to support a period of recovery. The service also offers advice on care solutions that can be provided in nursing homes to help avoid the need for people to be admitted to hospital, which also helps to keeps beds free. Dr. Claire Royston, Group Medical Director, said: “The service advises hospitals and care professionals on the availability of places in homes where there are qualified nurses and care staff able to deliver the appropriate care for the patient. While the patient is safely being cared for and recuperating in the home, their longer term care needs can be assessed with them and arrangements made. For instance, this may be for further rehabilitation and re-enablement in a care home, or as an outpatient, or a package of care support to return to their own home.”
The service is based on Four Seasons’ participation in an NHS England project to consider better use of nursing and care homes. Following a successful pilot exercise last winter the service has now been extended nationally in England and Scotland.
Case study: supporting transfer from hospital Mr Edward Jones was admitted to the Triangle Care Home in Oxfordshire to recuperate following a week’s stay in hospital with severe gastro enteritis. Although his symptoms were more under control, his immediate care needs meant he was not able to be discharged to return home.
Edward said: ”I know there is someone at hand to help me all the time. In fact, I have had a chest infection and the staff got in touch with a doctor from the hospital who came to examine me and gave me antibiotics and I am fine again now. “Triangle is a nice place to stay and I am well looked after. My daughter even came and had Christmas lunch with me here. I am getting stronger every day and I know that when the time comes to go home I will feel able to cope, but I will miss my new friends”
Case Study: avoiding hospital admission An elderly man who was living with dementia had a change in his behaviour that meant he could no longer be cared for at home by his wife supported by home care services. An ambulance and the police were involved. This happened at a weekend. The Social Worker called the rapid response service. The call was answered by Lisa Hindmarsh, co-ordinator for the North East region, who arranged for an immediate assessment of the gentleman, after which she arranged for him to be admitted that same day to Howdon Care Centre, where staff are trained to provide specialist dementia care. He spent a month in the home during which his behaviour settled and his longer term needs were assessed. Then he was able to be moved to a residential care setting closer to his home.