OXFORDSHIRE’S bedblocking crisis could be “eliminated” within two years by sending more hospital staff into the community, an NHS boss said.
Hospital director Paul Brennan said plans to send nurses into people’s homes could free up much-needed hospital beds.
The county has regularly been cited as England’s worst area for bedblocking, where a patient is well enough to go home, but does not.
This is often because Oxfordshire County Council, which runs social services, has not arranged home care quickly enough.
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The delay can have a major knock-on effect throughout hospitals – for example, operations can be cancelled because a ‘blocked’ bed.
Oxford University Hospitals NHS Trust began employing its own home carers in 2012 and has 36 supporting about 50 patients.
Now it is to employ four more nurses that will allow the trust to support about 80 patients in total – about half the number usually blocking hospital beds.
Latest figures show 148 were bedblocked at the end of August and Mr Brennan said about 100 are in the trust’s four hospitals.
These are Oxford’s John Radcliffe and Churchill hospitals, the Nuffield Orthopaedic Centre and Banbury’s Horton Hospital.
The others would be in community hospitals. These are not run by the trust but it has now got a licence to look after people discharged from them.
It is hoped the licence – given in July by the county council – will further tackle bedblocking in community hospitals such as Witney and Abingdon.
Mr Brennan said the changes, called the supported hospital discharge service, could cut bedblocking from 100 to 30 to 40 in two years.
He said: “This next stage of work, we feel, will eliminate the problem.
“We now employ staff who are carers and they work with the teams on the ward and when a patient needs to go home, instead of waiting for that care to be put in place they can provide it for us.”
The carers look after people at home for up to two weeks to give the council more time to sort out long-term care.
The trust said the nurses would be able to do a wider range of tasks like antibiotic infusions through a needle or catheter or difficult dressings.
The trust said: “The trust’s supported hospital discharge service helps reduce delays by enabling patients to go home sooner.”
Oxford East MP Andrew Smith said: “Eliminating delayed discharges is a welcome and important ambition.
“Acute hospitals are not the healthiest places for frail and elderly people who don’t have a medical need to be there.
“We will need more community nurses, and better pay for social care workers who are the people in the front line who will actually have to provide the care.”
Council spokesman Marcus Mabberley said: “We continue to work closely with our health colleagues to deal with the complex issue of delayed transfers of care.”
Paul Brennan
The trust is also in discussions with Oxford Health NHS Foundation Trust – which runs community hospitals – to work more closely together.
It wants to make better use of Oxford Health’s community facilities like rehabilitation teams and its reablement service.
Eliminating bedblocking is seen as key to ensuring the smooth operation of trust hospitals. Delays at the trust went from a rolling average of just over 100 beds blocked to 90 between January and August.
Staff have struggled to keep up with waiting targets because of rising patient numbers and an ageing population with multiple, complex conditions.
On Thursday, the Oxford Mail reported how the number of missed key targets rose from two out of 13 in 2012/13 to five out of 13 in 2013/14, including A&E and cancer waits.
The new scheme is a marked change from how the NHS has been organised since the ‘internal market’ was introduced under Margaret Thatcher in 1990.
Until then, health authorities ran a wide range of services, including hospital and home care.
But the changes gave councils and other NHS authorities budgets with which they then “bought” services from providers like hospital trusts.
This was aimed at introducing competition to drive up efficiency and led to many services like home care being divided between different authorities.
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