Bed blocking still a problem but winter initiatives worked

Initiatives to ease winter pressures on hospitals, including encouraging people to use alternatives to accident and emergency departments, have been successful.

Although figures for A&E admissions for Lincolnshire hospitals in the year to March 1 show an overall increase of 2,263 people (1.59 per cent), the figures for the last three months show attendances 4.14 per cent down on the same time last year – a total of 955 fewer people going to A&E during the winter months.

However, the figures also show that accident and emergency departments across the county have only hit the four-hour A&E waiting time target in 84.95 per cent of cases in the past three months and only 91.23 per cent of cases during the year – United Lincolnshire Hospital Trust’s own target is 95 per cent.

The figures are outlined in a report going before Lincolnshire County Council’s health scrutiny committee on Wednesday, which also show that 483 fewer emergency admissions were made to hospital in the three months to March compared to the same period last year.

The figure equates to a 4.97 per cent decrease on the same period in 2013/14, which the report also cites as evidence that winter pressure initiatives had worked.

These included the use of integrated “discharge hubs” in hospitals manned by multi-agency teams to ensure patients who were well enough were discharged from hospital to free up beds.

One of the major downfalls of the system which led to long waits in A&E had been due to delayed discharge of some patients, which meant beds were not available in other wards for emergency admissions.

Between April and December 2014, findings show that a total of 10,208 “bed days” were lost to delayed transfers of care – equivalent to 37 beds at 100 per cent occupancy.

Of these “lost days:

• 3,561 were due to a delay in completion of an assessment of their future care needs and identification of an appropriate care setting;
• 2,445 lost while patients awaited further NHS care, such as community or mental health care;
• 1,868 due to patients refusing offer of “reasonable” post-hospital care or patients insisting on waiting for a placement in a specific care home which had no vacancies.

The report adds: “The remaining challenge us to return Lincolnshire’s A&E performance to acceptable standards.”