Hospital bed block BHTA

Improved procurement policies, better integration of services, more occupational therapists and new tax incentives are some of the suggestions put forward by the British Healthcare Trades Association (BHTA) for tackling the issue of Delayed Transfer of Care, commonly referred to as ‘bed blocking’.

BHTA Bed blocking paper front coverIn its new paper, Action on Delayed Transfer of Care, the Trade Association presents a number of solutions for helping to reduce bed blocking, which, according to the NHS England statistics, saw over 200,000 delayed days across NHS Organisations in October 2016 and over 140,000 days in April 2018.

A review of the bed blocking cases identified in April found that many were the result of the delayed completion of assessments and postponed provision of community equipment and adaptations.

Underlining the sweeping impact bed blocking has on almost every area of healthcare provision, Lord Chris Rennard, BHTA Director of Communications, commented: “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.”

According to the paper, procurement policies could be improved in order to speed up the delivery of community equipment, enabling people to leave hospital quicker. The paper calls for delayed discharges to be treated as emergencies, with needs for equipment hurriedly identified and generally provided within five days.

Additionally, the paper says that an improvement in the management of Loan Stock Equipment could also help to reduce bed blocking.

“We believe that where there is an issue of ‘delayed discharge’ then the supply of equipment should generally be treated as an emergency” Mandie Lavin, Director-General of BHTA

The principle of combining health and care budgets is also strongly supported, emphasising that better integration of services can lead to better healthcare outcomes for patients, as well as cost savings.

Case studies of initiatives implemented in areas such as Norfolk, Manchester and Medway highlighted in the paper present examples of where better integration resulted in better care and cuts costs.

Conversely, the paper notes a particular case in Durham where the County Council selected a tender for the supply and maintenance of stairlifts across the county based on price. The contract was awarded to a company with a lower bid that was unable to match the quick turnaround of equipment than that of a slightly more expensive, local company. The result highlights the paper, was a short-term saving for the Council and a substantial additional cost for the NHS as a result of delayed discharges.

As well as procurement and integration, the paper also suggests that tax incentives should be introduced to encourage people purchasing homes with a view to retirement to plan ahead and make adaptations in anticipation of future needs.

The paper comes following plans announced at the NHS Confederation conference in June 2018 by Simon Stevens and Ian Dalton, the Chief Executives of NHS England and NHS Improvement, aiming to improve patient care by cutting long hospital stays.

Writing to Simon Stevens, Mandie Lavin, Director-General of the BHTA, said: “More rapid assessment of the need for community equipment and a more rapid procurement process could assist significantly to reduce the scale of the problem to everyone’s benefit.

“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. We believe that where there is an issue of ‘delayed discharge’ then the supply of equipment should generally be treated as an emergency.”

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