Get involved: send your photos, videos, news & views by texting 'OXFORD NEWS' to 80360 or email
Hospital beds are still blocked despite vows
Patients are still spending thousands of days in hospital unnecessarily, despite top-level assurance the problem would be in decline by now.
In an interview with the Oxford Mail last year, Dr Stephen Richards – the man tasked with tackling the problem – said there would be a real reduction in the number of well patients stuck in hospital beds by this spring.
Speaking in December when patients spent 5,327 days in hospital when they were fit to leave, he said: “I think we can expect a bit more turbulence. By March of this coming year we hope to have seen real progress.”
But according to figures obtained by the Oxford Mail, there has been little change.
Figures from the Department of Health for March show patients still spent 6,332 days stuck in hospital beds.
At the height of the problem – in October – there were 6,335.
Updated statistics for April – the most recent available – show a slight drop but still a high level at 5,775 days.
Dr Richards said seven initiatives had been introduced to tackle the issue, including more beds at community hospitals, a hospital-at-home service, and a crisis-response team people’s homes. But he admitted there had been ongoing recruitment problems.
He added: “It’s naturally taking time to build awareness of the services being introduced within the county and for health and social care professionals to become accustomed to using them.
“There have also been workforce issues.”
He was unable to say exactly in which areas there had been recruitment problems or provide a new timetable for solving the problem.
Patients well enough to leave hospital but awaiting arrangements for beds elsewhere or for social care to help them return home are classed as bedblockers.
The crisis first came to light in January 2011, after it was revealed non-urgent operations were being cancelled at Oxford’s John Radcliffe and Churchill hospitals and The Horton, in Banbury, because of a bed shortage.
This was blamed on delays discharging patients who no longer needed treatment but for whom discharge arrangements had not been made.
At the height of the problem, during October, an average of 200 people a day were stuck in Oxfordshire hospital beds.
Dr Richards said: “Increasing funding will not solve the problem. Recruitment issues continue and the systems and services already in place need to work better together to tackle the delays and avoid admissions in the first place.
“The NHS and the county council are continuing to work together to develop new ways of reducing the number of delays so people get home in a timely manner, with support to get back on to their feet quickly and long-term support for people to stay at home rather than hospital.
“We never expected numbers to reduce overnight however we hope the new services will have an effect on the number of unplanned admissions to hospital and the numbers of people delayed in getting out of hospital quicker.”
Dr Richards on the new initiatives: * Hospital-at-home: “Launched in the south of the county this has been rolled out north. The service provides extra medical and nursing support in people’s homes, where appropriate, to prevent unnecessary admissions to hospital and to let people to go home sooner from hospital with care such as intravenous antibiotics at home.”
* Crisis response: “During January a service was introduced to provide social care in people’s homes at times of crisis quickly. For example, if people already receive social care in their homes, they might need extra support and care to help them to manage their condition and to avoid hospital.”
* Supported discharge: “This enables the hospital to provide short term care at home while a long-term care package is put in place. Initially set up last year, the service has not had the progress we anticipated due to workforce recruitment difficulties. The Oxford University Hospitals NHS Trust has reviewed its approach and are recruiting more staff. They are confident the service will be at full strength by mid-July, helping reduce the number of delays significantly in the following few months.”
* Single point of access for community health: “Launched in May, the single point of access for community health services give GPs and healthcare professionals a single number to call when the need arises to refer patients to community health services. These include access to community hospital in-patient care, community matrons, specialist nurses, therapy, end-of-life care and respiratory service to name a few, and will expand to include mental health and social care. In due course it will also be available to clinicians to speed up discharge. Having one number means GPs and professionals can efficiently access services which could prevent admissions and get patients out of hospital again more efficiently. Our objective is to make it easier, where appropriate, to enable people to stay in their own home rather than hospital.”
* Reablement Service: “The reablement service is short-term focused support to help people regain confidence, rebuild skills and increase independence through therapeutic activities, such as improving mobility, building stamina and practising personal care, so they can manage on their own. This is a service best delivered outside acute hospitals either in community hospitals or homes. We have expanded the capacity of the reablement service, so by October it will pick up 25 more cases a week and deliver 3,250 more episodes of care a year. This will increase the chances of patients regaining relative independence in their own home and help get people discharged from hospital more quickly.”