Most of us will have a stay in hospital at some point in our lives, especially as we get older, but no-one likes to stay longer than is really necessary.
When you’re seriously ill or recovering from an accident or operation, hospital is the best place to be, but many patients end up staying long after they are medically fit for discharge.
This is usually because arrangements aren’t in place for them to receive the ongoing care they need at home or in another community-based setting. These prolonged stays in hospital can even lead to a deterioration in the patient’s physical and mental health, as well as occupying hospital beds needed for other patients – a situation known as ‘bed blocking’.
Now a new NHS initiative is being rolled out to help tens of thousands more people avoid lengthy and unnecessary stays in hospital. Called “Where Best Next?”, the campaign encourages hospital medical staff to regularly ask themselves if their patients need to remain in hospital or could be safely discharged? It aims to see around 140,000 people every year spared a hospital stay of three weeks or more.
As well as encouraging hospital staff to ask “Why not home? Why not today”, the scheme promotes more ‘joined-up’ working between hospitals and NHS medical teams offering care at home or in the community. In this way, patients can be discharged earlier, safe in the knowledge that they will still get the care they need, just in a different setting.
As well as being better for the patient, it is often better for their families, removing the burden of regular hospital visits. Patients and their families will be fully involved in decisions about the best time for discharge.
If the scheme hits its targets, it could also free up more than 7,000 NHS hospital beds for other patients who need them – the equivalent of building an extra 15 large hospitals. The knock-on effect would be to reduce waiting times for people needing non-emergency hospital treatment, such as a routine operation.
The campaign will see posters and other information placed in hospitals encouraging and reminding staff to take practical steps every day to get patients closer to a safe discharge, either to their own home or a more suitable alternative such as a care home or sheltered accommodation.
Nearly 350,000 patients currently spend more than three weeks in acute hospitals each year. Many are older people who are often frail, and while a short period of treatment in hospital is sometimes necessary, staying too long can leave them vulnerable to infections or physical ‘deconditioning’.
Research suggests more than a third of over-70s experience muscle ageing during a prolonged stay in hospital, rising to two-thirds of those aged over 90. It can leave some patients permanently less mobile or less able to perform tasks they could before going into hospital.
NHS medical director, Professor Stephen Powis, said: “We want to ensure that all patients benefit from the shortest possible stay on a ward, getting home as soon as they are fit to leave with the support they need. Not only is that better for them, reducing the risk of infection or loss of mobility for older people in particular, but it also means that more beds are available for others who need care too.”
Caroline Abrahams, charity director at Age UK, added: “Reducing the length of stay in hospital is crucial to an older person’s wellbeing and ultimately helps them regain their independence more quickly when they return home. That’s why it’s very important that older people are able to leave hospital as soon as they are medically fit.
“A swift discharge is only possible by having a discharge plan in place on admission which is shared across organisations. Most importantly, there must be joined-up services to fully support people at home when they are discharged to keep them well and avoid readmission.”