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Unblocking the System – ideas for improving hospital discharge

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‘Bed blocking’ is one of the biggest challenges facing health and social care.

A ‘bed blocker’ is a hospital patient who is medically fit and ready to leave but continues to occupy a bed.

However, ‘bed blocking’ is not a fair term – it’s rarely the patient’s fault, and has more to do with the system simply having nowhere for them to go.

Delayed transfers – as most prefer to call them – can be the result of delayed processes within the NHS, social care, or across both sectors, and can occur for a number of reasons.

One thing is certain, delayed transfers are damaging to both the patient and the system.

For the individual, longer stays in hospital are associated with increased risk of infection, low mood and reduced motivation, which can affect a patient’s health after they’ve been discharged and increase their chances of readmission to hospital.

The National Audit of Intermediate Care argues that, for older patients, a delay of more than two days negates the additional benefit of intermediate care, and seven days is associated with a 10% decline in muscle strength due to long periods of immobility in a hospital bed.

Delayed transfers of care also have a negative impact on the finances and performance of the health and care system. It’s expensive to keep a medically fit person in a hospital bed.

But, more importantly, delays in discharge also affect the flow of patients through a hospital.

As hospital admissions continue to rise, so the bed occupancy of the average hospital in England continues to exceed recommended levels. When a hospital is close to full capacity delayed transfers can mean there are no beds available for new admissions, with consequences for waiting times in A&E departments and for planned surgery.

So, what is being done about it? Well a lot is, but with mixed success.

Hospitals have been set tough reduction targets, and projects – like the Better Care Fund – were set up to encourage a more integrated approach.

However, at a time of great stress on the NHS and social care, where rising demand is not being matched with funding, delayed discharges continue to cripple the performance of many hospitals.

That’s why Health+Care Conference is running a debate on how to end ‘bed blocking’. Based on a campaign by home care provider Elder, a multi-disciplinary panel of experts on hospital discharge will consider and share solutions to the problem – and outline how social care providers can play a leading role.

The campaign calls for better data to really understand the scale of the problem, and the consideration of new, more holistic solutions.

Join us at 1.35pm on 27 June to learn more.

The speaker panel includes:

Chris Tuckett, Falls Prevention Practitioner and Physiotherapist, The Princess Alexandra Hospital NHS Trust

Oakley Walters, Director of Customer Acquisition at Elder

Dr Umesh Prabhu is a paediatric consultant and former medical director at Wigan & Leigh NHS Trust

Dr Ana Phelps, Service Delivery Unit Lead for Medicine for Older People, Buckinghamshire Healthcare NHS Trust

Author Mike Broad

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