The NHS is facing mounting pressures, and we are facing one of the toughest winters yet with huge demand for healthcare services and overburdened systems struggling to meet demand.
The reasons for these winter pressures are multifaceted. One of the major factors driving increased demand is the cost-of-living squeeze and increasing energy costs, with healthcare leaders warning that these financial issues could become a public health emergency. As temperatures lower and energy bills increase, the number of patients in hospital with respiratory infections are expected to cause an even worse capacity crisis than at the height of the Covid 19 pandemic.
Fuel poverty leading to cold homes exacerbate respiratory, circulatory and mental health problems across all ages, leading to more hospital admissions and a higher demand for social care services. The elderly are particularly at risk, as the cold causes the heart to work harder to keep the body warm, increasing the risk of a heart attack or stroke, as well as reducing dexterity leading to falls. The Welsh Government scientific advisors have warned the cost-of-living crisis may also accelerate waves of winter viruses by spreading quickly through crowded rooms of people trying to stay warm and save money on energy bills.
With waiting lists already at an all-time high, as well as significant challenges with discharging medically optimised patients, this winter could be even more bleak than originally expected. Re-admission to hospital is also more likely if patients are discharged back to cold and damp homes, which will worsen the problem.
The soaring costs of energy bills narrows the bandwidth for people to be able to look after their physical and mental health, due to worrying about money and not being able to afford to cook hot food, further increasing the chance of ill health and hospital admissions.
With unrelenting pressures being felt across the system, accelerating patient flow is the immediate and glaring opportunity to create sustainability in NHS England and NHS Wales and ultimately, protect patient outcomes. CHS Healthcare emphasises the need for a tactical approach to support the system in these unprecedented times and ensure patients are discharged with care in place to help keep them well. This way, we can alleviate winter pressures and create systems fit for the future to ease increasing pressures from expected influx of admissions. We suggest the NHS implement steps that focus on:
Active collaboration between hospitals, social care, families and providers from the moment a patient is admitted is critical. A system that works for patients needs hospital teams, social care services, families and providers working and planning together as early as possible. Our survey showed that in 31% of cases, hospital discharge is not discussed until treatment nears completion.
We need to adopt integrated system design and innovative care delivery models. To address the multi-faceted delays to patient flow we must bring together knowledge and skills from across the entire health and care sector. Discharge is everybody’s business.
Building on the digital infrastructure enables more effective case management, better monitoring of complex cases and ensures adequate resource is available by addressing inefficiencies. Digital technology also helps us manage and measure patient flow across the system.
We shouldn’t wait until patients are better before engaging with their family and next of kin. 92% of staff agreed that engaging with the patient’s family and carers early on makes a successful discharge.
We hope that English and Welsh health boards will clearly set out how they will address the pressure fuel poverty has on patient flow. Without this, we cannot hope to move increasing patients efficiently in and out of hospital on a national scale.
Find out more about our work with front-line staff and senior NHS leaders to uncover the patient flow challenge, and how CHS Healthcare can help you to optimise patient flow, here.