More than 20 patients a day in Shropshire have unnecessary stay

In a single month, a combined 565 days were spent by patients across the county waiting to be discharged or transferred to a different care facility.

Figures from NHS England, which are for February, showed patients at Telford’s Princess Royal Hospital and Royal Shrewsbury Hospital spent 238 days waiting to be discharged or transferred – equivalent to more than seven months.

Nigel Lee, chief operating officer at The Shrewsbury and Telford Hospital NHS Trust, said the winter period had seen a significant rise in demand for emergency care in its hospitals.

He said: "Together with our system partners we have worked to provide the correct care in hospital, and also ensure a timely discharge to a patient’s home or other care facility.

“We have worked very hard to reduce the level of patients remaining in hospital once they are medically fit, and Sath now ranks in the top three in England for reducing longer lengths of stay.

“Together with the community teams, clinical commissioning groups and local authorities, we have also halved the numbers of patients that are medically fit and awaiting transfer compared to last year, and routinely transfer most patients within 48 hours of being fit, which is the national standard."

He said the trust continues to look at ways of improving further.

Complex

At Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, which runs the orthopaedic hospital in Gobowen, a total of 268 days were spent by patients waiting, during the same month.

The trust said it is working with care providers and commissioners to reduce the number of delayed transfers of care, to improve the overall care of patients.

Nia Jones, director of operations, said: “The aim is ultimately to be able to discharge our patients as soon as they are medically fit, while ensuring that they have the right rehabilitation and care package in their home setting.”

Meanwhile, patients at Shropshire Community Health NHS Trust, which runs community hospitals across the county, spent a total of 59 days waiting to be discharged or transferred.

Steve Gregory, director of nursing at the trust, said: “It is important that patients are cared for in the most appropriate setting for their needs.

“These figures relate to a small handful of patients with complex needs that must be met so that they can be discharged or transferred safely. Sometimes it takes longer than we would like to enable the right support or service to be available.

“We work with others within the Shropshire care system to make sure any delay is kept to a minimum and, where possible, we look for learning or system changes that would help in similar situations in future.”

A delayed transfer of care occurs when a patient remains in a bed after being officially declared safe for transfer by both a doctor and a multidisciplinary team, which could include social or mental health care workers.

Delays can be caused by problems within the NHS, like waiting for a bed to open up in a rehabilitation centre or mental health hospital, or problems with social care, such as delays in setting up community care or special equipment at home.

Delays in transferring a patient between wards, or from one acute hospital to another, are not included.

'Fragmented care'

The Care Quality Commission said that it recommends a more joined-up approach to health and social care to tackle delays.

A CQC spokesperson said: "There is too much ineffective coordination of local health and care services – leading to fragmented care for older people.

"Our measures would reflect the contribution of all health and care organisations, rather than relying primarily on information collected by acute hospitals."

Across England, an average of 4,546 beds were blocked each day in February, resulting in a total of 127,281 delayed days – equivalent to just under 350 years of lost time.

The rate peaked in February 2017, when 6,660 beds were lost to bed blocking each day, but has fallen steadily since then. Last year, it was 5,013 per day.

Bed blocking has fallen at all three trusts compared to the same month last year.

According to the NHS, a hospital stay of more than 10 days for a person over 80 can lead to 10 years of muscle ageing.

An NHS England spokesperson said: “Thanks to better joint working between hospitals and social care teams, thousands more people were able to return home with the right support quicker after a spell in hospital this winter, freeing up hundreds of beds every day for other patients who need hospital care.”