A new NHS campaign is aiming to reduce the number of people remaining in hospital because they do not have the right home support after recovering from an operation or an illness.
The ‘Where Best Next?’ campaign is being rolled out nationwide and hopes to see around 140,000 people every year spared a hospital stay of three weeks or more. The drive could free up more than 7,000 beds for other patients – the equivalent of building an extra 15 large hospitals.
Developed in partnership with Royal Colleges, the Local Government Association and patient groups like Age UK, it will focus on reminding ward staff of five principles when planning care:
- Planning for discharge from the point someone is admitted, and ensuring that plan is shared with the whole team and the patient;
- Involving patients and their families in discharge decisions, and telling them the benefits of leaving hospital at the right time;
- Identifying frail patients as soon as possible and making a specific plan for their care;
- Having weekly multi-disciplinary team reviews for all long stay patients, and;
- Encouraging a ‘home first’ approach, including assessing people at home where possible.
NHS medical director, Professor Stephen Powis, said: “I know how hard frontline NHS staff and their council colleagues have worked hard over the last year to reduce delays in discharging patients, but we want to ensure that all patients benefit from the shortest possible stay on a ward, getting home as soon as they are fit to leave with the support they need.
“Not only is that better for them, reducing the risk of infection or loss of mobility for older people in particular, but it also means that more beds are available for others who need care too, easing pressure on A&E and other parts of the system.”
Short hospital stays are better for vulnerable older people
Nearly 350,000 patients currently spend over three weeks in acute hospitals each year. Many of those are older people who are often frail, and while a short period of treatment in hospital is sometimes necessary, staying too long can leave them vulnerable to infections or deconditioning.
Research suggests that more than one in three 70-year-olds experience muscle ageing during a prolonged stay in hospital, rising to two thirds of those aged over 90, which can leave some permanently less mobile or able to perform tasks they could before.
Caroline Abrahams, charity director at Age UK, said: “Reducing the length of stay in hospital is crucial to an older person’s well-being and ultimately helps them regain their independence more quickly when they return home.
“That’s why it’s very important that older people are able to leave hospital as soon as they are medically fit. A swift discharge is only possible by having a discharge plan in place on admission which is shared across organisations. Most importantly, there must be joined up services to fully support people at home when they are discharged to keep them well and avoid readmission.”
Figures on delayed transfers of care, which measure the number of extra days someone spends in hospital after they have been declared medically fit to leave, show that in June an average of 4,500 people each day were experiencing such a delay – down almost a quarter from the same month two years ago.
NHS leaders now want to quadruple progress on delivering shorter stays, with a suite of resources and activities designed to help hospital staff plan the right care and interventions – including wherever possible avoiding a hospital admission completely.