The national rate of delayed transfers of care has soared to its highest ever level, threatening the better care fund’s ambition to cut costs by improving the transfer of patients from hospital to other care settings.
HSJ analysis of official figures has revealed a 7 per cent rise in the number of days patients’ discharge from hospitals have been delayed - from 1.4 million over 12 months to September 2013-14 to 1.5 million over the same period to September 2014-15.
This increasing rate has gathered momentum over the past 12 months and follows two years of being broadly flat.
According to our analysis, the annual rate began its ascent above 1.39 million in September last year after hovering at around 1.38 million over 25 months from August 2011 - the first time there was a full year of data available.
Delayed transfers of care are a key metric for the better care fund.
As part of the initiative, each area must explain how their integration plans will reduce the number of delayed transfers.
The rate has risen more than 6 per cent since last December, when delayed transfers of care were first named as a measure for judging the fund’s performance.
According to NHS England and the Department of Health, the total predicted cuts to delayed transfers across all better care fund plans totals 100,962 delayed days by the end of 2015-16 - a 7.5 per cent fall from the baseline year of 2013-14.
This would bring the rate down to about 1.3 million delayed days per year - the lowest level they have been since they were reported in their current form in 2010.
However, HSJ analysis shows the annual rate of delayed transfers has risen by more than 77,000 since the end of 2013-14, when the baseline was set.
Such a situation will require a fall by about 12 per cent from their current peak and a reversal on the current sharply increasing trend in order for the better care fund’s ambition to reduce delayed transfers is to be achieved.
Based on an average bed day cost of around £300, the better care fund’s total projected savings through cutting delayed transfers only amount to £31m - around 6 per cent of the total planned better care fund savings.
Many health economies believe delayed transfers are one of the most problematic performance challenges they face.
This is because each delayed day has a knock-on effect on hospital capacity and the ability for trusts to admit patients for either elective or emergency care.
King’s Fund policy director Richard Murray said HSJ’s analysis supports “a consistent picture of rising distress in the system”.
He added that the delayed transfer rate, as it is currently published, was “probably the tip of the iceberg” of what trusts were experiencing as it underestimates the strain delayed transfers were put on the system.
“There will be other patients that have not gone through all the admin and bureaucracy about being classified as delayed, but do not need to be in hospital,” he said.
NHS England’s figures show that the total number of delays for which NHS organisations are responsible is rising as a proportion of the total, while the number caused by social care providers is falling.
This aspect of the data is disputed, however.
Last year Commons health committee said the figures were “incredible” because they contradicted accounts from senior NHS clinicians who said that social care was increasingly to blame. But the DH retorted that both it and NHS England were confident in the credibility of the data.