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Eyes on the prize

Our exclusive on Monday that NHS national leaders have estimated the service is at least 4,000 beds short for next winter and are pushing for fresh funding this year to help plug the deficit raises a number of issues.

It’s not unusual for the NHS to ask for more cash (or get it). But a cash boost would mark a significant policy change, after the NHS England planning guidance published in February said “there will be no additional winter funding in 2018-19”.

The NHS’s 70th birthday and debate about a longer term funding settlement are, of course, convenient for the cause, but does the service have sufficient credibility in the bank with the Treasury to get it?

It is no secret that those in the Treasury and Number 10 have not been impressed by the NHS’s apparent lack of financial grip. But one area NHS bosses are convinced they can show an ability to (at least partly) deliver on a plan is delayed discharges.

The NHS actually missed its flagship delayed transfer of discharge target (reducing DTOCs to 3.5 per cent of bed base by September). But there is no doubt the system made a good dent in the problem, which had been building for years.

System leaders will this year argue that with similar support they will be able to make a the same type of impression on another large problem: the length of stay of “stranded” and “super stranded” patients, who have been in hospital for more than seven or 21 days respectively.

The prize on offer for cutting length of stay (when clinically safe) is huge. HSJ was told if the NHS reduced its super stranded patients by 25 per cent this would release the equivalent of 4,000 beds alone.