Meeting: Board Meeting Date: 27.08.14 Agenda Item: 9.3 Paper No: 45/1415 Approval Discussion For noting Action Presented by: Mr. Alexander Brown, Nurse Director TITLE: DELAYED DISCHARGES AUGUST 2014 Purpose of paper: The Board is asked to: Note the report for information Executive Summary: Detailed summary of the full report highlighting the salient points. To provide an update to Board on the number of patients affected by delayed discharges and recorded at the weekly monitoring meeting as well as the occupied bed days associated with those patients. Delayed discharges are presented in two formats for this report attached as appendices. An update of the cumulative bed days attributed to delayed discharges for the period January 2011 to June 2014 (appendix 1) - and by quarterly trend for the period January 2011 to June 2014 (appendix 2) An analysis of the monthly average for occupied bed days displays the more stable pattern in 2012 with a decreased average occupancy and less variation between months. A comparison across years for the autumn/winter period (Oct to March), reveals a marked escalation in 2013/14 to an average of 602 per month, a three-fold increase from the previous two periods (204 in 2012/13, and 202 in 2011/12). This has further increased to a peak of 881 occupied bed days in May 2014. The quarterly analysis reveals the almost linear increases since 2013 culminating in a monthly average for the last reporting period of 757 occupied bed days. The weekly management report for the 1 st week in August indicates that 20 people were reported as delayed discharges, 19 of whom were waiting over 4 weeks. Three people met the criteria for reporting within waiting times targets. Those waiting above the 4 week target are attributable to awaiting long term Care Home or Nursing Home provision and carers in localities, 16 awaiting nursing/care home, 3 awaiting carers.
Link to Corporate/ Strategic Objectives: To provide person centered care, focusing on the health needs of the population, and identifying opportunities for improving patients experience, to reduce time and resources consumed by activities that add no value to the patient. To continue to ensure delivery and continuous improvement of a range of high quality effective health improvement, health protection and health care services to the people of the Western Isles within the financial and other resources available, and by working in partnership with our staff and the people we serve. Governance Impact: Financial Impact Describe the impact on all the relevant Governance Standards Include costs & funding source The average cost per bed day attributed to a delayed discharge patient is 259.62. This is derived from direct pool costs associated with WIH and excluding allocated costs. Clinical Governance Demonstrate how the report impacts on monitoring and improving the quality of our services and safeguarding high standards of patient focused care and services. Potential for elective patients to be denied admission to the Western isles Hospital due to blocked beds. Staff Governance Patient & Public Involvement Best Value Demonstrate how the report impacts on improvements in relation to a system of corporate accountability for the fair and effective management of staff. Include evidence of planned involvement Please indicate which parts of the Best Value Framework are evidenced by this paper.
Link to the Quality Strategy: Six Dimensions of the Quality Strategy Please indicate which of the six dimensions are supported in this paper - Person- Centred Providing care that is responsive to individual person preferences, needs and values and assuring that patient values guide all clinical decisions. Safe Effective Efficient Equitable Timely Avoiding injuries to patients from healthcare that is intended to help them. Providing services based on scientific knowledge. Avoiding waste, including waste of equipment, supplies, ideas and energy. Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, or social economic status. Reducing waits and sometimes harmful delays for both those who receive care and those who give care. Risk Assessment Principal Risks related to this paper: (Including Risk Rating) Is a Risk Assessment included within the full report. Please describe the outcome of any risk assessments relating to this, whether it is on the NHS Western Isles Risk Register and what is being done to minimise the risk. Yes No Fairness Assessment (If No please explain why an assessment is not required) Is a Fairness Assessment necessary and if so, include within the full report. Requirements to impact assess all polices and functions and to include reference to impact assessment of the issue at hand. Yes No Parties consulted with: Consulted with: Date(s): Committees presented to: Presented to: Weekly Delayed discharge meetings. Quarterly Health and Social Care Committee Corporate Management Team Date(s):
Communicate the document with: e.g. Website / intranet / other staff or committee groups Full report located: Reference should be made to where individuals can obtain a copy of the full report.
Appendix 1 Appendix 2 Jan December 2011-2014