Our hospitals are extremely busy at this time of year, and enabling patients to go home promptly is almost as important as the treatment they receive while here.
About 100 patients leave our hospitals every day having completed their treatment but there are others equally eligible who stay put through no fault of their own.
Currently one in ten inpatients are medically ready to be discharged but still occupying beds, and our winter plans include a concerted drive to halve the rate.
Ideally we would like to discharge one third of those whose treatment is finished by 11am each morning. At the moment we are only managing 13% and are working through a number of quality improvement schemes to tackle this.
Some wards are adopting “golden discharge” principles, including maximising the use of discharge lounges. Yet often our patients are dependent on others to prepare the way with arranging care places, domestic adaptations, home therapies, or oxygen and drug supplies.
A daily review and focus on the ten patients who have waited longest – 10 before 10am - is particularly effective. Benchmarking data suggests that on average our patients stay half a day longer than at peer hospitals.
The challenge is urgent because we are now into the busiest period of the winter season, and optimising discharge opportunities is the best way to manage peak demand for beds.
One initiative working to speed up the flow within our hospitals is Transfer 24, an initiative within the Barts Health Group to take patients from other hospitals within 24 hours if we can transfer them back within 24 hours.
Rebecca Carlton, group chief operating officer, said:
Patients may need specialist trauma, renal or neuro treatment at regional centres like The Royal London but can recover just as well in their local hospital.
This is about how much more we can do to make it easy for ourselves, by doing what is in our gift to support patients who are ready for discharge. It does require everyone to work together to take patients back, so we can ensure beds are ready for others to receive the urgent, specialist treatment we provide.
If we can extend the principle across north east London, it would greatly benefit patients who would be closer to home and their support networks.
On average we have about 30 patients awaiting repatriation, half within the group and half externally, yet since October we have reduced the numbers waiting for internal transfer by a quarter