Delayed transfers: Beyond the headlines

James Thompson Data Analyst, The King’s Fund

› Why delayed transfers? › Patients waiting › Hospital flow

› What data is available? *Health warning* › Number of patients delayed – monthly census › Number of days delayed – total counted over whole

month

What the data shows Delayed transfers: Patients and days delayed

Data source: Acute and non–acute delayed transfers of care, patient snapshot and total days delayed, 2013/14 http://www.england.nhs.uk/statistics/statistical-work-areas/delayed-transfers-of-care/delayed-transfers-of-care-data-2013-14/

What NHS managers are saying

Cuts to local authority spending had impact on service in last year

Delayed discharges have increased

Source: NHS Confederation Papering over the cracks: the impact of social care funding on the NHS http://www.nhsconfed.org/Publications/Documents/papering-over-cracks.pdf

What NHS managers are saying

What do we know about these delayed patients?

Data source: Acute and non–acute delayed transfers of care, patient snapshot and total days delayed, 2013/14 http://www.england.nhs.uk/statistics/statistical-work-areas/delayed-transfers-of-care/delayed-transfers-of-care-data-2013-14/

What is the impact on the system? Daily hospital bed occupancy rate, general and acute beds, England

Data Source: Winter pressures daily situation reports, 2013/14 data http://www.england.nhs.uk/statistics/statistical-work-areas/winter-daily-sitreps/winter-pressures-daily-sitrep-2013-14-data-2/

What is the impact on the system?

A social care issue?

Total days delayed by responsible organisation

Data source: Acute and non–acute delayed transfers of care, total days delayed, 2013/14 http://www.england.nhs.uk/statistics/statistical-work-areas/delayed-transfers-of-care/delayed-transfers-of-care-data-2013-14

A social care issue?

Attributable to NHS

Attributable to Social Care

Attributable to both

A. Awaiting completion of assessment B. Awaiting public funding C. Awaiting further non-acute (including community and mental health) NHS care (including intermediate care, rehabilitation services etc)

D i). Awaiting residential home placement or availability

D ii). Awaiting nursing home placement or availability

E. Awaiting care package in own home F. Awaiting community equipment and adaptations

G. Patient or Family choice H. Disputes I. Housing – patients not covered by NHS and Community Care Act

Reasons for delayed transfer of care

Source: NHS England, Monthly delayed transfer of care SitReps, Definitions and guidance http://www.england.nhs.uk/statistics/statistical-work-areas/delayed-transfers-of-care/

A social care issue?

Data source: Delayed transfers of care statistics for England 2012/13, NHS England http://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2013/04/Annex-3-Annual-report-2012-13.pdf

In conclusion › NHS professionals versus official statistics

› still unclear

› What to do with the numbers?

› echo Health Select Committees call for data review

› Can we delay any longer?

› www.kingsfund.org.uk/qmr