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Action on Delayed Transfer of Care – Lib Dem peer Lord Rennard writes about the problems and solutions

November 8, 2018 8:57 PM
By Lord Chris Rennard
Originally published by LDDA - The Liberal Democrat Disability Association

Lord Rennard has written the foreword for a paper 'Action on Delayed Transfer of Care' produced by the British Healthcare Trades Association (BHTA). The paper has been sent to MPs and peers most closely associated with health and disability issues as well as relevant Ministers and civil servants.

One of the issues identified in the paper is how delays in the provision of suitable equipment can mean that too many patients are made to stay in hospital for far longer than necessary. Integrating properly the health and care services is seen as essential to reduce what is commonly known as 'bed blocking'.

This is a link to the paper: http://bit.ly/2NKnx5U

Below is the start of the article, which might be helpful as a graphic.

Foreward by Lord Chris Rennard MBE

"Speaking at the NHS Confederation conference In June 2018, Simon Stevens and Ian Dalton, the Chief Executives of NHS England and NHS Improvement, announced plans to improve patient care by cutting long hospital stays.

Delayed transfer of care causes distress for patients and their families and is a particular problem for many older people, especially those who are frail and may have dementia. Their conditions often deteriorate whilst in hospital and there can be significant muscle wastage due to lack of physical activity.

The number of 'delayed days' has been reduced significantly in the last two years, but is still far higher than the figures for 2010, as the health and social care system struggles to cope with the consequences of considerable demographic changes.

More rapid assessment in hospital, addressing the shortage of Occupational Therapists, and greater provision of Trusted Trained Assessors could all help to address the problem. Everyone agrees that greater integration of health and social care systems is crucial. There is already some evidence of how delayed transfer of care can be reduced, and cost savings achieved to fund other aspects of healthcare, where relevant budgets are combined, as in Greater Manchester.

Investment in research and development has also enabled British manufacturers and suppliers to provide some of the best equipment in the world to help more elderly and disabled people live independently out of hospital. More rapid assessment of the need for community equipment, and a more appropriate procurement process prioritising speed of delivery, could assist significantly in reducing the scale of the problem to everyone's benefit.

Too many patients wait too long for specialist equipment such as stairlifts or hoists to be provided in their homes before they can be discharged. When needs have been assessed, tenders for the necessary equipment are very largely based upon price (inevitably) and to a lesser degree on quality. But speed of delivery and the opportunity to reduce 'bed blocking' should also be a significant priority.

Bar codes and similar identifiers using Global Standards 1 (GS1) standards (now adopted across the NHS) should be used to identify where relevant Loan Stock equipment is located, and who is responsible for it, in order to make faster connections between staff, patients and products. This would help to reduce the number of times that a discharge is delayed simply because a patient is waiting to be supplied with equipment that may be no more complicated than a walking frame and commode.

This paper demonstrates how a more holistic and structured procurement process with a focus on effective delivery of homecare equipment and services can have major impact on speeding up hospital discharges and improving overall healthcare provision."

Lord Rennard MBE

Director of Communications

BHTA