The must-read stories and debate in health policy and leadership.
Concerns have been swirling for a while that “new hospital” projects may end up too small.
The National Audit Office flagged this as a potential issue last summer, saying there were still question marks over ideas underpinning designs such as higher than normal occupancy levels due to single rooms.
The New Hospital Programme suggested previously that it could reduce bed numbers by 14 per cent, on the basis that new hospitals would be more efficient and more care would be given in the community.
This appears to be driven by NHS England wanting more evidence before locking into these assumed benefits. Its chiefs were quizzed quite heavily over the idea of 95 per cent occupancy – higher than the current aim – by MPs last year and stressed this was still being tested.
All of this depends on what the Treasury says about the new programme business case, which HSJ understands is asking for more money as well.
This could be crucial for schemes which have estimated their current funding would result in fewer beds, or remove entire wards from scope.
Virtual reality
The big rollout of virtual wards over the last year has come with the assumption they would help reduce pressure on hospitals and deliver financial savings at the same time.
Yet a study in the North West suggests the hoped-for financial savings will prove elusive, and virtual wards may actually increase costs substantially.
The study at Wrightington Wigan and Leigh Teaching Hospitals, which involved 318 virtual ward patients, found a clear reduction in length of stay, but also higher rates of readmission.
The authors said this led to additional costs, with the cost of a bed day in the virtual ward estimated at £935, compared to £536 in a general inpatient hospital bed.
The study’s authors said the findings should raise concerns over a flagship NHSE policy, which has driven the establishment of 10,000 virtual ward beds.
NHSE dismissed the findings, claiming the study was “misleading” because of its limited size and time span of just one year.
But when invited to point to other research papers offering a more comprehensive analysis, it failed to do so. One example featured on its website involved fewer than 50 virtual ward patients, over a period of six months.
Also on hsj.co.uk today
In The Integrator, Dave West says the regime for assessing and rating integrated care boards could get a shake-up as soon as this summer. And in Comment, Roger Klein says the NHS’s overreliance on the Bradford Factor is potentially discriminatory.
