The Providers Deliver series gives us a great opportunity to stand back and celebrate some of the extraordinary work that trusts and their staff do, often in difficult circumstances.
This time we’re looking at the vitally important issue of ‘patient flow’. All too often attention is drawn exclusively to headline waiting times in urgent and emergency care, but we know the drivers of long-waits and delays for patients are complex with no one single solution and that they impact acute, mental health, community and ambulance services.
Demographic changes, deteriorating population health and widening health inequalities over recent years mean demand for all health and care services has risen. Patients are presenting with greater acuity and complex needs often exacerbated by a broader cost of living crisis. At the same time, insufficient capacity, resources and investment across health and care services, including in social care, mental health and community care services, mean people too often experience a delay in accessing the care they need and in being discharged from hospital.
A lack of capacity in community and mental health care can also limit the NHS’ ability to offer preventative care and reduce avoidable hospital admissions.
These are all factors driving very high bed occupancy rates, which in turn means admissions are delayed and urgent and emergency care pathways become overstretched, creating a pressurised working environment for staff and unacceptable delays for patients. In this challenging context, we deliberately set out to highlight some of the practical steps and innovations trusts have taken to improve how patients get the care they need, in the right place at the right time.
The case studies in this report show how trusts are working collaboratively to prevent avoidable admissions, manage demand more effectively, build additional capacity sustainably, use technology to deliver more care in community settings, and deliver real improvements in patients’ experience of accessing the health and care they need in a timely way.
In the most challenging of circumstances trusts, and their staff, continue to innovate. As the NHS works towards sustainable recovery from the pandemic and to reduce waiting times for all services, it is clear that a preventative whole-system approach will be key. With the right support, trusts are well positioned to deliver.
Sir Julian Hartley
Chief Executive
NHS Providers