Council achieves current target in getting people out of hospital sooner
Shropshire Council’s adult social care has achieved its current target in ensuring that patients don’t stay in hospital longer than they need to.
The service was required to improve its target to reduce the number of patients who are delayed in hospital (known as a Delayed Transfer of Care) by 60% by September 2017. The service has exceeded this target, achieving 75%.
A Delayed Transfer of Care from acute or non-acute care occurs when a patient is ready to depart and is still occupying a hospital bed.
Adult social care services, as well as acute settings such as hospitals, across England, are expected to maintain or reduce the number of patients who are delayed in such circumstances. The Government has set each organisation a target to reduce the delays of transfers of care.
The Delayed Transfer of Care figures, produced by NHS England, show that during the current year the monthly number of delayed bed days has reduced. The council’s adult social care service have seen month-on-month improvements during the reporting period.
Shropshire Council’s adult social care has implemented a number of actions to improve Delayed Transfers of Care since July 2017. New programmes and initiatives to help patients return home sooner, or support those to avoid hospital admission, include:
Bespoke night time support (Two carers in a car) – This pilot scheme involves two carers who can travel to any household within the Shrewsbury area to provide support between 10pm and 7am. This support may be assistance for toilet care, to getting into bed at a later time than when regular carers are available, reassurance if just home from hospital, or as an alternative to a hospital admission where night support is required. Request for placements are often due to night support being required, but many people do not need this throughout the whole night. This scheme enables care support to be provided to a number of people throughout the night.
Carer support post-hospital discharge – Carers Trust 4all are offering support for carers discharged from hospital. Carers may feel anxious following a discharge that they have lost their routine, or the person they support on discharge may require more support. This service is now available throughout Shropshire, and is provided directly for the benefit of the carer at a time of increased challenges for the carer.
Extra care units – Where additional support is needed but can’t be provided within the person’s home, the council has commissioned four new ‘independence’ units located within a local housing development. These units are individually self-contained, where couples or single people can live, and where they can continue to receive therapeutic and care support prior to, and during, their transition when moving back to their own home. These units will be particularly beneficial for those discharged patients not able to return home from hospital. They will provide people with the environment where they can continue to regain and improve their ability to live in their own home, which for many people is what they wish to achieve, and evidence demonstrates is difficult to achieve if admitted to residential placements. This will allow people who require a period of enablement in an environment where they can be accompanied by their partner and receive further support to develop their independence skills.
Let’s Talk Local hub – There is also the hospital-based ‘Let’s Talk Local’ hub, which will offer information and advice around visiting times for people who are supporting friends, neighbours, and family members who are in hospital.
Lee Chapman, Shropshire Council’s Cabinet member for health, adult social care and housing, said:
“No one wishes to be in hospital longer than is necessary, and in adult social care we work to support people to be discharged as soon as they are well. We are delighted that in September we exceeded the target that had been set nationally for us.
“I would like to offer my congratulations to all those involved who I know have worked extremely hard to ensure that people return home from hospital as soon as possible. This is a great result from the team.”
The Health and Adult Social Care Overview and Scrutiny Committee (meeting held Monday 20 November am) asked for a presentation on Delayed Transfers of Care, commonly referred to as DTOC, in Shropshire. You can view the full report https://shropshire.gov.uk/committee-services/ieListDocuments.aspx?CId=737&MId=3610&Ver=4
A delayed transfer of care from acute or non-acute care occurs when a patient is ready to depart from such care and is still occupying a bed. A patient is ready for transfer when:
- A clinical decision has been made that patient is ready for transfer and
- A multi-disciplinary team decision has been made that patient is ready for transfer and
- The patient is safe to discharge or transfer.