By Gabrielle Silver
This week at NHS Providers, Simon Stevens spoke about acute hospital capacity heading into winter: “… we want to go into the winter with as many hospital beds open as we can – ideally more than last year. In June I said, looking at evidence, we should not be planning on the basis that there will be further reductions in acute hospital beds over the next five years, and [it’s] important, as people are doing their long term implementation plans locally, they are thinking carefully about that.”
But is this the right currency to focus on in terms of capacity? At first glance it seems logical that more beds should be considered a useful lever to create capacity over winter. However, when you set this against a backdrop of 350,000 patients spending more than 21 days in hospital, trusts missing targets on helping these super stranded patients out of hospital and into care, as well as many trusts already using escalation beds, it seems that the real capacity in the system is unknown. The beds that should be made available are those that are occupied by these super stranded patients – until these beds are put back into the system can we really be sure that there is a need to open and staff ‘new’ beds?
A practical and achievable intervention to release this capacity is intensive working with the family and carers of patients. We’ve been working with trusts undertaking family liaison for many years and have seen first-hand how dedicated support focussed on understanding patient needs, being available after hours and at weekends, as well as taking family members on visits to care homes can support them to make an otherwise daunting decision. With this all round approach, we discharge all patients in 10 days or less. It’s this support which could really make a difference over the coming months without the need to put more beds into a system which struggles to cope as it is.