Insights

Chris Rose: 5 minute read

Delayed Transfers of Care - where are we now?

Much like the fabled, Green Paper for Social Care, Delayed Transfers of Care seem to have been forgotten about. Only to be heard of in passing and used alongside much bigger stories but what should we take from this? Should we assume now that the problems have subsided and are under control? Should we take this as the delays have reduced and no longer cost the NHS nearly a billion a year? Or do we take it that other concerns have overshadowed those associated with Delayed Transfers of Care?

The history

A term that was coined in 2010, bed blocking refers to the long-term occupation of hospital beds, chiefly by elderly people, due to a shortage of suitable care elsewhere. It is a term that has negative connotations. Many organisations, OLM included, have dropped the term and refer to the situation as Delayed Transfers of Care (DToC). Regardless of the term used, we can all agree that £900 million per year and the impact on the lives of the individuals is too great.

Seeing the damage that DToC was beginning to cause, the government allocated one billion pounds to help alleviate the situation in 2017. The funding was allocated to all local authorities, with the authorities that topped the list of delays, receiving the highest level of funding. This was designed to plug the gap between hospitals and local authorities. The main delays occurring because there was no on-going care available.

Despite the increase in funding more than 40% of hospitals still acknowledged that they would be unable to guarantee patients care that Christmas. Hospital bosses at the time claimed that many local authorities were failing to put this emergency funding into schemes to get patients home quicker. Social care support was not being improved and was in danger of falling over during the Christmas period but did this became reality or was it fear-mongering?

Where are we now?

In April of this year, the NHS in England revealed that there were 130,800 total delayed days, which is a reduction of 3.3% from the previous year. This figure is based on the delays attributable to social care. It shows a clear downward trend in terms of the journey that we are on to alleviate the pressures associated with DToC.

This is great news but it is only a start and there were still more than 130,000 total delayed days due to DToC, further highlighting the need for the Green Paper. This long-overdue paper has turned into a poison challis for politicians on both sides of the house and at this point, we do need to know if it will make the difference that we all hope it will when it arrives.

More hyped than the final season of Game of Thrones, The Green Paper is likely to fall as flat, with more promise than delivery. This is a hypothesis that was echoed earlier this year by Caroline Dinage MP. At the annual ADASS Spring Conference, she hinted that local authorities need to get on with it. The Green Paper will arrive but it will not be the silver bullet that many are hoping for.

Your destinies (local authorities) are in your hands and the time to act is now.

What does the future hold?

It would be very easy to hold our heads in our hands and worry about Brexit, budget cuts and Green Paper but this would not get us anywhere. We are living in an era where the power to change lies in our hands and technology is here to assist with this change.

The government is pre-occupied with party politics and Brexit. The needs of every man, woman and child have become almost secondary, with delays in the publishing of the Green Paper being a testament to this. The power to save the NHS and bring social care in line with expectations is in our hands.

The future is bright but we need to be brave enough to seize it. Yes, there are challenges on the horizon such as the aforementioned, Brexit but as we have seen with the DToC figures, improvements can be made. These can be made through changes in working combined with the benefits that modern technology provides.

Technology is key

Phrases such as ‘Cloud-native’, ‘Responsive design’ and ‘Two-Factor authentication’ dominate headlines but what do they mean. In a nutshell, they mean freedom for workers to concentrate on their jobs and give more time back for patients. This is person-centred care and gets patients to the environment that is best suited to them as quickly as possible.

DToC has a human cost associated with it in the fact that for every day an elderly patient remains in the hospital they lose 5% of their muscle strength. As time goes on, this accumulation of muscle strength loss can lead to additional complications and in extreme circumstances, death. This is not person-centred and technology has improved the discharge process.

Hertfordshire County Council saw the benefits that technology could bring two years ago. They set up a partnership between themselves, the care provider’s association and the NHS in their area. The goal of which was to work with a technology supplier to change the manner in which discharges were processed. Linking the patient to the required ongoing care as quickly as possible being the core goal.

ECLIPSE Bed Management and Hertfordshire County Council

With over 300 care home providers in the region, Hertfordshire County Council needed a way of monitoring bookings in real-time. They needed to be able to see where vacancies lie and easily fill them without the hassle of calling around to every home in the area. The previous process revolved around a team of ‘Bed Finders’ manually calling all of the homes in the area to find a suitable vacancy. As you can imagine this was inefficient and accentuated the problems associated with DToC.

They turned to OLM and our ECLIPSE Bed Management solution. The solution removes the considerable time spent calling around to care homes trying to find a suitable home. In its place, the user now only needs to check the easy-to-use web solution for vacancies and book the space online. The time-saving nature of this change in the process is priceless. Members of staff can are able to focus and use the additional time to spend with those who need help the most.

The solution reduces the time spent looking for a suitable bed vacancy by more than 50%. In addition to increased efficiency, the solution is intuitive and prevents double bookings. Once someone has reserved a room, it is passed over to the care home to approve or decline. The decision rests solely with the care provider. Only they have the power to amend the solution, with email reminders and updates being automatically generated. Being intuitive and easy-to-use means that little to no training is required and this dramatically reduces the cost of ownership.

Conclusion

Delayed Transfers of Care are still a problem in 2019. Even though there has been a year-on-year reduction of more than 3%, there were still more than 130,000-bed delays that can be associated with DToC. It is something that will take time to fully reduce and something that needs to be monitored. Short term measures will not suffice here.

Technology has paved the way towards independence and reducing the number of delays but there are still mountains to climb. The situation is reducing, yes, but it needs to be maintained with the new processes that have cropped up with the new technology that has been developed.

What we don’t want to see is that after ten years, the systems that are now in place, that are assisting in reducing delays are discontinued. These new ways of working with technology are part of a new paradigm and one that will underpin the discharge process from hospital to social care and need to be maintained. Only this way, will we keep on top of the situation and continue to make a difference with regards to Delayed Transfers of Care.