NHS England looking at plans to speed up discharge of medically fit patients

By Jane Kirby, Reporter12th October 2022News EnglandAccident and Emergency, Hospitals, Integrated Care, News England, NHS, Social Care

NHS England is looking at new plans to speed up the discharge of people stuck in hospital beds who are medically fit to leave.

Hospitals are under increasing pressure due to delayed discharges – where people cannot leave beds due to a lack of facilities or support for them in the community.

This has a huge knock-on effect, leading to a lack of hospital beds, longer waits in A&E and delays for ambulances waiting to hand over patients.

NHS data analysed by the PA news agency last month shows the number of people stuck in hospital beds who are fit to be discharged is on the increase and currently higher than last winter.

In August, an average of 13,388 people per day were in beds but were fit to leave.

In contrast, the figure was 10,925 people per day last December, 12,201 in January this year and 12,025 in February.

In north-west England, an average of 3,308 patients a day were ready to be discharged in August, but only 29% actually left – the highest proportion for any region.

Now, the NHS is looking at plans for a universal “community recovery service” with a 24-hour target to provide step-down care once a patient is deemed ready to leave hospital.

According to the Health Service Journal (HSJ), slides presented to an NHS England webinar showed it is seeking to pilot “one single intermediate care step-down service (organised) at place through one lead commissioner”.

It would include a target, or standard, requiring that when patients no longer meet the “criteria to reside in hospital”, they enter the new community recovery service within 24 hours.

It suggested that the “vision” is that this 24-hour standard is met for all acute hospital patients within five years.

Jenny Keane, NHSE’s national director for intermediate care and rehabilitation, told the webinar that the new service would aim to address the “siloed working” of many current rehabilitation services.

According to HSJ, she said: “It’s not that intermediate care doesn’t exist out there, but they have been built upon in a very ad-hoc way, very often with non-recurrent, intermittent-type funding. They are funded through social care and the NHS, which adds to the complexity.

“We know there are a lot of patients who are not getting the appropriate input in this service that has a really strong focus on rehabilitation and recovery, with the right individuals leading that.”

Matthew Winn, NHSE’s director of community health, told the webinar: “We have to move to a service, both bedded care or at home, that flexes, and the intensity of the support wraps around the person.”

An NHS spokesman said on Wednesday: “The proposal for a community recovery service is in its initial stages and is being developed in conjunction with key partners.

“We are exploring how to enable more patients to leave hospital and receive the care and treatment they need closer to home, ideally in their own home, to boost recovery times and increase capacity in hospitals.

“NHS England will be further testing and evaluating this proposal over the next 12 months.”