Delayed transfers of care: join the queue

Between June 2010 and January 2014, there was little movement in the total number of delayed days but 2014/15 saw a dramatic increase. The total number of delayed days increased by 15 per cent – 211,000 days – in 2014/15 compared to the previous year.

Though the figures for the first five months of 2015/16 show this increase has moderated, figures for this year still represent an 11 per cent increase on 2014/15 (Figure 1).

Alongside the increasing number of delayed days, there has been a change in the cause of these delays. From 2010 through to the end of 2014, there was an increase in the number of delayed delays attributable to the NHS, but this figure has been declining since the beginning of 2015. In August 2015, the number of NHS-attributable delayed days was 2 per cent lower than the same month last year, while the number of delays attributable to social care was more than 20 per cent higher (Figure 2).

So why is this? Compared to the same quarter last year, in the first quarter of 2015/16 there were substantial increases in the number of patients waiting for the implementation of care packages to support them in their own home (76 per cent) and patients waiting for residential (21 per cent) and nursing home (11 per cent) places (Figure 3) – all of which we might class as delays attributable to social care.

This reflects the pressure that social care has been under recently – between 2009/10 and 2013/14 social care funding has fallen by £1.8 billion in real terms. And in our own latest quarterly monitoring report, 79 of the 90 NHS trust finance directors who took part told us that they felt funding pressures on local authorities have had a negative impact on the performance of health services in their local health economies.

However, when we are considering delayed transfers of care we need to remember that there are some questions around the quality of the data, as we have previously argued. We aren’t convinced that the reported numbers reflect the experience of delayed transfers across England. Currently, the data is only for patients aged over 18, it doesn’t include acute-to-acute transfers and, following conversations with some NHS professionals, we feel there are variations in how local areas are reporting delays.

At a time when resources for all sectors are being stretched to their limits, and with the flurry of admissions that winter normally brings close on the horizon, delayed transfers of care makes for grim reading. Hopefully NHS Providers can supply some more upbeat stories from their commission this week.