• Mid and South Essex STP chair hails major DTOC improvement
  • Co-location of NHS and council teams a major driver in upturn says chair
  • Staff education about decline of long stay patients also big help, say managers

Mid and South Essex sustainability and transformation partnership, a success regime area which covers one of England’s most pressured health economies, cut its delayed discharges by two thirds in a year, its chair has revealed.

Speaking ahead of an announcement on a major acute reconfiguration on Friday, STP chair Anita Donley admitted the local system remained hugely challenged, but she said local leaders were “growing in confidence”.

A major driver of improvements on delayed transfers has been the recent move to co-locate NHS and social care staff and establish a “joint hospital discharge team with a social worker on-site at [Basildon] hospital,” she said.

Dr Donley added: “This has helped enable a reduction in delayed discharges between February 2017 and February 2018 of 66 per cent. That’s down from 300 people to one hundred in that year which is very significant in terms of bed days.”

Local managers told HSJ a series of cultural and operations shifts, including co-locating NHS and social care staff and rota changes to improve weekend discharges, had been behind the upturn.

The most significant improvements have been at Basildon and Thurrock Hospitals Foundation Trust. Delayed discharges have been cut from around 130 days per month, over the target of up to 129, to 48 days, in a six month period.

Lynne Jacobs, an Essex County Council service manager, said: “The Basildon NHS and council teams have been co-located in the same office for about a year now and this has really improved joined-up working.

“We also instilled a culture whereby people are fully aware of the patient benefits of getting them back out of hospital as quickly as possible.

“We educate our teams about the deterioration which can take place if a frail elderly person spends too long in hospital.”

The STP has a projected £550m deficit by 2020. Its three acute trusts, Basildon, Southend University Hospital FT and Mid Essex Hospital Services Trust, who are pursuing a formal merger, are set to make decisions on a significant reconfiguration on Friday.

The wide ranging service shake-up involves making Basildon the major emergency centre for the patch, which has generated considerable debate around the safety of increased transfers between hospitals.

Stroke services are also set to be reconfigured with local leaders having previously discussed implementing a London-style stroke network across the three trusts, with Basildon designated the hyper acute stroke unit.