Patients who don’t need to be in hospital add to burden on NHS

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MORE than 500 patients were in hospital when they didn’t need to be – taking up bed space that could be allocated to others.

The News obtained figures through the Freedom of Information act, which shows that last year 532 patients were in Queen Alexandra Hospital, in Cosham, when they didn’t need to be.

Thousands of people need hospital care

Thousands of people need hospital care

These patients spent a total of 3,740 days in acute care, when they should have been taken into a community setting.

Today, in our final investigation for Under Pressure Week, The News takes a look health trusts which provide community help to help patients get back to normal life after receiving hospital care.

Mike Quinn is director of medicine for Portsmouth Hospitals NHS Trust, which runs QA.

He said: ‘Often what presents to us in A&E is the unknown.

‘You don’t know what conditions or problems that patient has, so you are unaware of their complexities.

‘That is the fundamental issue we have – with a planned patient you are armed with a lot more information about them.

‘The discharge planning process has already started, which means as soon as they have treatment they can leave.

‘But that’s not the same with emergency patients, and often we can only start dealing with different agencies when a patient is better.

‘There are frustrations around this, and things become out of sync with timings.

‘For instance a nursing home may only take three new people in a week, so even if they have empty beds, they may not take a patient in.

‘Sometimes families want a bit of a break and think it’s okay to leave a family member in hospital.

‘And other times adaptations need to be made in a home, so until they are done, a patient is still in hospital.’

Mr Quinn said that a hospital is not the right place to be if a person is feeling well.

He added: ‘Acute care is only really short term – once you are better you need to have the next stage of your care ready.

‘Being in hospital is psychologically hard for some patients, and you are more prone to pick up bugs, as you’re around unwell people.

There’s a lot that needs to be done to break down myths.

‘Families also have a responsibilty.

‘We understand there are difficulties, but it would help if some criteria could be changed.’

Solent NHS Trust is the main community and mental health provider for Portsmouth.

Solent said the Portsmouth Rehabilitation and Reablement Team (PRRT) and the introduction of a pilot scheme called Inreach has helped discharge patients from QA quicker.

Sarah Austin, director of strategy, said: ‘The current success in reducing delayed discharges can be directly attributed to two really important initiatives – the PRRT and a pilot project called Inreach.

‘PRRT is a multi-disciplinary team that includes community nurses, community physiotherapist, occupational therapists, and social care services.

‘It has a pooled budget between health and social care so that when someone needs to come home quickly, and needs a six-week package of support, they get it without any prolonged debate.

‘That speeds up discharge and means the patient gets what they need at home quickly.

‘Our Inreach nurses are piloting a new approach where they go into the hospital to identity patients that could come home and then rapidly organise home services to be in place for their prompt discharge.’

Solent said it looks after around 1,000 patients in the Portsmouth area.

Ms Austin added: ‘We’re encouraged by results of the partnership work in Portsmouth as we are now discharging patients far more quickly than before.

‘We generally have fewer than 10 patients at any one time waiting in QA, who are ready to go home.

‘Often these patients are waiting less than a day for final arrangements to be made to bring them home safely.

‘Of course, there is still a lot more work to do, and we are continuously looking at innovative ways to ensure our patients are looked after in the most appropriate environment, which in most cases is their own homes.’

Southern Health NHS Foundation Trust, which provides services for Hampshire, said it employs community matrons, whose role is to prevent hospital admissions.

They work closely with GPs, who alert Southern Health teams to high risk patients. Once a call is received about a patient from a GP, the matron will carry out a physical assessment, prescribe accordingly and put together a care plan for the patient.

This is to help prevent a patient becoming so ill, or hurting themselves, that it warrants A&E admission.

Portsmouth City Council said it had no reportable delays attributable to adult social care at QA for the past three years.

Hampshire County Council were unavailable for comment.

ALL week The News has focused on different aspects of healthcare in the Portsmouth area.

The aim is to let readers know what options they have and when each should be used.

People can now fill out a survey to help Clinical Commissioning Groups, who buy in health services and help them see what patients think.

There are three CCGs covering the area ­– Portsmouth; Fareham and Gosport; and South Eastern Hampshire.

Mark Waldron, editor of The News, said: ‘We’ve delivered a week-long look at various aspects of NHS care.

‘I’m grateful to all the organisations that gave us an opportunity to find out more about what they do, and when is the best time to call on them.

‘We’ve passed this message on to you, our readers.

‘But it’s also important to us, and the CCGs, to hear what you have to say by taking part in a simple, short survey.

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