CHS Healthcare receives national coverage in The Telegraph, shining a light on the current state of affairs with super stranded patients in trusts.
We work closely with many hospital trusts and local authorities to help patients out of hospital and into the care they need. We know that medically fit patients are waiting too long to leave hospital, but not how big of a problem this is.
To further delve into this, we commissioned some new research using NHS England and NHS Improvement data. The data reveals that there were 330,826 super stranded patients in England from April 2018 to March 2019. The NHS defines a super stranded patient as someone who has spent 21 days or more in hospital.
Over the same period, the data shows that nearly 80,000 operations have been cancelled at the last minute for non-clinical reasons, including bed availability. This equates to more than 200 operations cancelled every single day.
With three months to go before winter and flu season – a time when the need for capacity is high – almost 90 per cent of NHS trusts in England are not meeting their target to reduce the number of super stranded patients. Between January and March this year alone, the average monthly number of these patients was 17,047.
You can see how trusts are performing against their targets on our interactive map.
The data shows the impact that lengthy discharge has on patient flow. It reveals that between January and March 2019 those hospitals missing their super stranded target could have undertaken an additional 17,715 operations were there no other contributing factors*.
Our chief executive, Dr Gabrielle Silver, said:
“Although we often hear about the challenge facing the front door of hospitals – illustrated by queuing ambulances – it’s critical to address issues at the back door. Elderly people sat needlessly in beds on wards across England is the ignored face of poor patient flow.
“The impact of an extended stay in hospital can’t be underestimated in terms of risk of further illness and physical or mental decline. NHS England made a commitment to improve patient care by cutting long stays in hospital and there are some effective schemes in place but overall not enough is being done.
“With the challenges of winter and flu season fast approaching, NHS trusts need to dedicate resource now to supporting super stranded patients into care in their own home or in the community. This will ensure operations can continue to be performed and there is maximum capacity to meet the needs of local people during winter.”
We work with Kettering General Hospital NHS Foundation Trust and are part of the team that work with super stranded patients weekly on their wards. Kettering are also one of the 13% of trusts meeting their super stranded patient targets. Fiona Lennon, Deputy Chief Operating Officer at Kettering General Hospital NHS Foundation Trust, said:
“We know how important it is for the timely discharge of patients when they are medically fit to be discharged. At our trust, we have been focusing on reducing the numbers of stranded and super stranded patients, which we’ve seen is helping to improve patient flow and most importantly, making sure that patients are getting the right care in the right place.”
NHS England and NHS Improvement data used includes:
- The most recent figures (Jan-March 2019) for the number of super stranded patients
(SSP) at each trust with their respective long-stay ambition – Excel
- Super stranded patients across trusts for 2018/19 – Excel
- Last-minute elective surgery operations cancelled for non-clinical reasons:
- Yearly figures: http://www.england.nhs.uk/statistics/cancelled-elective-operations/
- January – March figures: http://www.england.nhs.uk/statistics/cancelled-elective-operations/cancelled-ops-data/
The NHS Operational Planning and Contracting Guidance 2019/20 set a target to reduce the number of super stranded patients in hospitals by 25 per cent across all NHS trusts nationally, to release at least 4,000 beds. Once local targets are delivered, NHS England and NHS Improvement aims to reduce the proportion of beds occupied by super stranded patients by a total of 40 per cent.
NHS Improvement has recorded that 35 per cent of 70-year-old patients experience functional decline during hospital admission in comparison with their pre-illness baseline;
for people over 90, this increases to 65 per cent.
*Non-clinical reasons for cancelling operations include:
- NO beds available on a ward
- Staff are not available, such as the surgeon, anaesthetist or operating theatre staff
- An emergency case had to take priority in the operating theatre
- Some equipment is not working