Dramatic reduction in delayed transfers from hospital show evidence of more joined-up working between health and social care

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Figures that show the number of patients who are in hospital beds, even though they are fit to leave, have reached a new low for Staffordshire patients.

Figures verified today show that the number of patients in hospital unnecessarily has fallen by over 40 per cent in the last 12 months. They are now lower than they have been for many years and comparable to the rates for Stoke-on-Trent.

Officially called Delayed Transfers of Care (DTOCs), it means patients who don’t need to be in hospital are in a bed because the support they need to live at home is not available. Staying in a hospital bed unnecessarily can rapidly lead to Deconditioning Syndrome - serious muscle wastage and loss of confidence – especially for patients who are frail and elderly.

Figures are calculated based on each single day every individual patient is in hospital unnecessarily per calendar month. In May 2019 the figure for Staffordshire patients was 2,714. This compares to 4,754 in March 2018, with figures around the 4,000 mark until summer of last year. 

Heather Johnstone, Staffordshire and Stoke-on-Trent CCG’s Director of Quality and Nursing said: “This is excellent news for our patients, for the NHS and for the partners we work with in Local Authorities.

“This is really about getting people safely and promptly out of hospital, to a place where they are best placed to be supported, whether it’s their own home, a care home or hospice. This is overwhelmingly in the best interest of patients.

“It also means more hospital beds are available for people who really need to be there. 

“The validated figures mean that we have reached our national target for the first time for Staffordshire patients. The main challenge has been “repatriating” patients from Staffordshire who are being treated in hospitals outside the county or Stoke-on-Trent.”

The news comes following inspections by the watchdog Care Quality Commission into services for older people in both Staffordshire (December 2018) and Stoke-on-Trent (January 2019). The report into Stoke-on-Trent showed “significant improvement in the health (and) social care system for older people”.

Heather Johnstone added: “Getting the number of DTOCs to zero is not a realistic aspiration because of reasons that are beyond our control, but we want to see the downward trend continue, and are confident it will once the figures for June and July are validated.

 “It’s too simplistic to view delayed transfers as either a social care or NHS problem because they can occur for a number of reasons, but what has worked in Staffordshire and Stoke-on-Trent is removing the barriers between health and social care to do what is right for the patient.

“Reducing DTOCs has in no small part played a role in our hugely improved urgent and emergency care performance across all our providers.

“It is also evidence that our Discharge to Assess model, where patients are discharged from hospital and have their needs assessed as soon as they are back home, is now working across much of Staffordshire in the way it has been in Stoke-on-Trent for some time.”

Alan White, Deputy Leader and Cabinet Member for Health, Care and Wellbeing for Staffordshire County Council said: “The reduction in DTOC demonstrates the improvements we have made in health and social care in the last year. We are working more closely together to avoid hospital admissions where possible, manage frail and elderly people better whilst they are in hospital, and reduce unnecessary waits at the point of discharge.

“We have also invested in additional services to support people in the community. These include ‘discharge to assess’ services which support people for a short period after hospital discharge, whilst their longer term care needs can be assessed and arranged.”