Southampton: Hospital's plan to reduce 'bed blockers'

Patients occupying hospital beds when they are medically fit to leave are costing the NHS millions of pounds

Hospital chiefs are hoping to reduce the number of medically fit patients
Author: Jason Lewis, Local Democracy Reporting ServicePublished 1st May 2024

Health bosses in Southampton have set a “significant ambition” of halving the number of patients who occupy hospital beds when they are medically fit to leave.

University Hospital Southampton currently sees around 200 patients with no criteria to reside (NCTR) in acute beds at any one time.

Members of the city council’s health overview and scrutiny panel were told these situations were not best for the patient and the NHS.

James House, Southampton place director for NHS Hampshire and Isle of Wight Integrated Care Board, said it was a “perineal issue” which was “really complex”.

He said it involved there not being enough capacity in social care and workforce challenges, as well as over-prescribing and over-medicalising people.

Mr House told the panel: “We have got quite a significant ambition this year which is to try and reduce the number of NCTR patients by half.

“Whether that is achievable or not, who knows, and we are still working through the underlying detail to that, but that is the ambition we have set ourselves and that’s what we think we should be striving for.”

The hospital has launched an internal programme to assess how patients can be discharged more quickly, how they can leave with less dependency on care and how to keep them moving while in hospital to prevent deconditioning.

The panel was told the financial impact of existing levels of NCTR patients was in the millions of pounds a year.

Duncan Linning-Karp, University Hospital Southampton’s deputy chief operating officer, said every winter elective surgeries had to be cancelled due to not having enough beds.

He said there was a “really big evidence base” that post-Covid people are going to hospital and leaving hospital sicker.

“We are just seeing a more unwell population than we were seeing pre-Covid and we can see that in everything we are doing as a hospital,” Mr Linning-Karp said.

“We can see that in our length of stay post-surgery, we can see that in the pathways patients are going down leaving hospital and that people are leaving hospital with greater care needs.”

He added: “You can speculate on the reasons for that but from the data, it is what is happening. That is putting more pressure on the council and the community about what they need and what we need.”

The integrated care board is convening a discharge board with the hospital, community health trusts and the council to bring partners together.

Claire Edger, Southampton City Council executive director of wellbeing and housing, said there needed to be more focus on hospital avoidance and prevention.

She said there had been a failure to look at what was going on before people went into hospital.

Asked what success would like, Mr House said: “Ideally, this is something that we wouldn’t want any patient to have to go through.

“In an ideal world, we want to see zero patients waiting to leave. At the end of the day, this is a queue. This is a queue for patients that are not necessarily in the place we want them to be or they want to be.

“Realistically, if we could get the 50 per cent reduction this year, I think that would be amazing.

“That would be a huge benefit and we would obviously be looking to push that forward in future years.”

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