Are delayed transfers a growing problem?

This content relates to the following topics:

Comments

Stephanie de l…

Position
Chair,
Organisation
Business boosters network CIC
Comment date
14 February 2013
The more worrying issues are now that companies such as Arriva plc are now gaining NHS contracts for non Emergancy transfers by undercutting tenders. Their Cqc report is very poor on patient care and even issues with communications, the latest win for them is Sheffield and Manchester and the back lash is now in the media. The need to reduce 20 bil for the NhS is now seeing more of these quality care reductions and can only become more apparent. The health minister may well say that the NhS has to make sure patient care and quality must not be compromised but the reality is that commissoners are hell bent at reducing the bottom line on the accounts. This when we have not yet even had the transfer to CCGs and well being boards

Sarah Pickup

Position
President ADASS,
Organisation
ADASS/Hertfordshire CC
Comment date
14 February 2013
I think one of the issues may be about perceptions of delays. the pressure on acute beds is such that there is an urgency to move people out and presumptions are often made about who should be responsible and social care is often asked to help or take responsibility even when the official definition woudl not count. With people deemed ready for discharge ever earlier, their level of needs at that point is higher and more complex services are needed to safely get them home- these can take time to arrange. It is often also the case that people arranging their own care and taking time to make choices, people whose homes need adaptation, people who need a CHC/FNC assessment are all perceived as " waiting for social care". It is alsoi the case that no-one ever mentions the changes in the volume sof requests to social care for support nor who is discharged and what is achieved... the counting is all about the delays. We need to stop the blame game and get everyone working to ensure people have the rigt acre in the right place at the right time and we use our joint public funds to best effect to achieve this.

Gaurish Chawla

Position
@keen_student,
Comment date
17 February 2013
Some interesting points have been made above. What we also need to do is to look at how each of the trusts is trying to deal with this problem, and share the lessons. For example, Huddersfield and Calderdale NHS Foundation Trust implemented a Lean programme in the trust to tackle a few problems, one of which was delayed discharges. Their service improvement officer Tania King has reported massive reductions in delayed discharges. I believe there is a lot we can all learn from their example.
Below is a link to a presentation by her, where she describes how they achieved their objectives.

leanuk.org/pages/event_summit_2011_speaker_king.htm

PS I am not affiliated to the trust or the lean enterprise academy.

Trevor

Comment date
11 March 2013
By keeping people in hospital once their acute needs are met, both health and social care are doing patients a big disservice - because they physically decompensate and are at all sorts of risks (reduced mobility, falls, infection) as a result.

This is a story as much about NHS community services, and how commissioning fails to encourage them to pull patients out of hospital in a timely manner, as about social care's response. However, lets not pretend that the government's 28% cut in local authority budgets does not place restrictions on social services assessment and support package capability to NHS patients. Surely ADASS should highlight this.

Looking at an area by area breakdown of the offical DTOC figures illustrates how inconsistently they are reported. I suspect though that ministers never want this properly investigated for fear of what an even bigger problem they will find.

Shireen

Position
Manager,
Organisation
Mental Health NHS Trust
Comment date
14 March 2013
With the on-going decommissioning of beds in Mental Health ' to decrease the estate foot-print within Trusts rather than staffing and to offer up cost savings to Whitehall', as mentioned above, more and more patients are being discharged earlier to unsafe and poorly equipped 'recovery houses', local hotels and hostels. They are more more often than not under-treated and with limited community care follow up due to serious understaffing. DTOC meetings are tense affairs. Housing stock is limited, the bureaucracy of endless funding panels, poor quality private accomodation as in residential or supported accomodation contribute to a dismal, revolving door situation. The statistics might show a reduction in DTOC, but it would be useful to get the figures for the rates of re-admission.

Add your comment