Partners must address long-term challenges to promote independence, says Auditor General
Fewer people in Wales are suffering delayed transfers of care because of a more co-ordinated approach from senior management to tackling the problem. To sustain such improvement local partners in health and social care, and the Assembly Government, must take a longer term approach and seize opportunities arising from the restructuring of the NHS.
This is the conclusion of a report released today by the Auditor General for Wales, which tracks progress made since his suite of reports in 2007. These found that the independence of vulnerable older people was compromised by unnecessary delays in hospital because the problem of delayed transfers of care had not been tackled in a co-ordinated way across the whole system of health and social care.
A delayed transfer of care occurs when a patient is ready to transfer out of hospital but is prevented by non-clinical reasons. Being delayed in hospital is bad for people because they can lose mobility, mental and physical function and ultimately their independence. Such delays also harm wider service delivery and performance across the whole health and social care system.
The report, 'Delayed transfers of care follow-through', looks at delayed transfers of care in the Cardiff and Vale of Glamorgan and Gwent areas, and has found evidence of some improvements. Cardiff and Vale of Glamorgan reduced the number of lost bed days by 24 per cent (2006-07 to 2007-08), while the number of people who experienced a delayed transfer also decreased by 20 per cent over this period. In Gwent there had also been a considerable reduction in the number of people experiencing delays, falling from 148 in June 2008 to 56 in December 2008.
Delayed transfers of care affect the people who suffer a delay, the people who need the beds occupied by delayed patients, and cost the NHS money. The report estimates that the direct cost of these bed days across Wales due to delayed transfers of care in 2007-08 was over £66 million, an improvement on the 2006-07 figure of £69 million.
The report finds that the Assembly Government has taken positive steps to tackle delayed transfers of care but also identified the need for a clear vision of how health and social care partners should tackle the whole systems problems manifested by delayed transfers of care.
The report recognises the forthcoming reconfiguration on the NHS in Wales presents an opportunity to address these problems more robustly. It also highlights short-term risks which partners will need to manage.
The report makes a number of recommendations for further improvement, both for the partners in health and social care communities and for the Assembly Government.
Recommendations to local partners include:
Recommendations to the Assembly Government include:
Auditor General for Wales, Jeremy Colman, said today:
"Hospital delays can have a very negative effect on the independence of vulnerable older patients. I am pleased to note the improvements in the impact and extent of delayed transfers of care, and the more serious approach taken by the Assembly Government and local partners since our first report.
There remains, however, a need for the Assembly Government to consider my recommendations and in particular to take advantage of the opportunities to develop a more robust holistic approach to promoting independence which the ongoing reconfiguration of the NHS in Wales may provide."
Notes to Editors: