• Ten trusts visited by NHS England “central support” team to “accelerate” delayed transfers of care initiatives
  • FOI revealed the team initially shortlisted 33 trusts at “high risk” of delayed transfers
  • NHS England also drew up a list of trusts that must “prioritise” plans to implement A&E streaming services

Ten hospital trusts have been visited by a special NHS England team to “accelerate” initiatives dealing with delayed transfers of care, HSJ can reveal.

The 10 visits were completed by February and each trust (see box) will have a follow up “progress review and support to access best practice” coordinated through regional teams. The trust names were given to HSJ following a freedom of information request.

Southampton General Hospital

Southampton General Hospital

University Hospital Southampton was one of the trusts visited by NHS England

An NHS England board paper from December said the visits would focus on “agreeing ways to rapidly reduce DTOCs with partner organisations”. It added: “These systems will also be subject to closer monitoring and intervention.”

The paper also said NHS England had established a “central support team” to help reduce delayed transfers. The national commissioner declined to name people on the team “as they are not NHS England employees”, but the paper said it includes acute trust chief executives, clinical commissioning group accountable officers and “senior leaders from local authorities who haven a proven track record of successfully reducing DTOCs”.

The 10 visited trusts were those with the most “high risk systems”, which included those with DTOC rates above 8 per cent, a high proportion of NHS related delays and places where “discharge to assess” home based assessment models are yet to be implemented.

One to the 10 was University Hospital Southampton Foundation Trust. A spokesman said: “We have agreed a target that there will be no more than 36 such patients waiting within hospital beds by March 2018. Solutions being introduced include new staff focused on supporting people to through the process of moving from hospital to care at home or in community beds and greater capacity so that more people can be cared for at home or in residential or nursing homes in the community.”

The other trusts did not respond to HSJ by the time of publication.

The 10 trusts visited by NHS England over high DTOC rates

  • Hillingdon Hospitals FT
  • Cambridge University Hospital FT
  • Peterborough and Stamford Hospitals FT
  • The Princess Alexandra Hospital Trust
  • Northampton General Hospital Trust
  • North Cumbria University Hospitals Trust
  • Stockport FT
  • Royal Cornwall Hospitals Trust
  • University Hospital Southampton FT
  • Weston Area Health Trust

The FOI response revealed that the support team had initially drawn up a list of 33 trusts with “high risk systems” where DTOC performance improvements were “potentially required”. It said the list was based on “performance data, information provided about progress on their A&E improvement plans, and NHS England and NHS Improvement regional team judgement”. Of the 33, five were from London, seven from the Midlands and East, 14 from the North and seven from the South.

Twenty-three were removed from the list after “further inspection” as they were not “considered to require any kind of intervention, support, or further assurance” (see box). An NHS England spokeswoman said it was “unable to confirm” details of these further inspections as they “varied” between regions and “depended on local circumstances and issues”.

However, Kettering General Hospital Trust, which was one of the 33, said in a September board paper that it had submitted “an assessment of local A&E delivery boards and DTOC acceleration” document to, which outlined the “DTOC recovery trajectory and the associated interventions which would be implemented by the system to aid the DTOC recovery.”

Another of the 33, Airedale FT said in a November board paper that it hadresponded to a request from NHSI to undertake a snapshot bed audit on Tuesday 15 November 2016”.

The 23 trusts identified as high risk but not visited

  • Chelsea and Westminster Hospital FT
  • Croydon Health Service Trust
  • University College London Hospitals FT
  • Epsom and St Helier University Hospitals Trust
  • Kettering General Hospital FT
  • Hinchingbrooke Health Care Trust
  • Norfolk and Norwich University Hospitals FT
  • Airedale FT
  • Bolton FT
  • Bradford Teaching Hospitals FT
  • Central Manchester University Hospitals FT
  • East Cheshire Trust
  • Harrogate and District Foundation Trust
  • Mid Cheshire Hospitals FT
  • North Tees and Hartlepool FT
  • Southport and Ormskirk Hospital Trust
  • St Helens and Knowsley Hospitals Trust
  • University Hospital of South Manchester FT
  • York Teaching Hospital FT
  • Hampshire Hospitals FT
  • Northern Devon Healthcare Trust
  • Taunton and Somerset FT
  • Yeovil District Hospital FT

The FOI response also revealed a list of 32 trusts identified as “high risk” for concerns that A&E “streaming/co-located services” would not be “up and running by Christmas” 2016 (see box). These were recognised as “requiring further assurance” based on performance data, information provided about progress on A&E improvement plans and NHSI regional team judgement. Some were later removed from the list upon “further inspection”, however NHS England has declined to say which, if any, of the trusts remain on the list.

The December NHS England board paper said the trusts on the list would have to “prioritise and accelerate plans to stand up streaming services at the front door”. It added: “The requirement is for every single acute provide to have streaming/co-located services during peak hours in the first instance, expanding to 12 hours per day minimum in the medium term.”

The 32 trusts identified as high risk for A&E streaming/co-located services

  • Kingston Hospital FT
  • Bedford Hospital Trust
  • Derby Teaching Hospitals FT
  • East and North Hertfordshire Trust
  • Hinchingbrooke Health Care Trust
  • Kettering General Hospital FT
  • Nottingham University Hospitals Trust
  • Peterborough and Stamford Hospitals FT
  • University Hospitals Coventry and Warwickshire Trust
  • West Suffolk FT
  • Worcestershire Acute Hospitals Trust
  • Wye Valley Trust
  • Calderdale and Huddersfield FT
  • East Lancashire Hospitals Trust
  • Leeds Teaching Hospitals Trust
  • Mid Cheshire Hospitals FT
  • North Tees and Hartlepool FT
  • Penine Acute Hospitals FT
  • St Helens and Knowsley Hospitals Trust
  • University Hospitals of Morecombe Bay FT
  • Ashford and St Peter’s Hospitals Foundation Trust
  • Brighton and Sussex University Hospitals Trust
  • Dorset County Hospital FT
  • East Kent Hospitals University FT
  • North Bristol Trust
  • Poole Hospital FT
  • Portsmouth Hospitals Trust
  • Royal Surrey County Hospital FT
  • Taunton and Somerset FT
  • Torbay and South Devon FT
  • Western Sussex Hospitals FT
  • Weston Area Health Trust