Delayed discharge is expensive and entirely preventable. Plus, why are ambulances being held up?

Home is where the care is

The rise in non-acute delayed transfers of care is extremely worrying, costs the NHS hundreds of millions of pounds, and fails to give patients the standard of care they deserve.

It is also entirely preventable. When the right services are in place there is no need for vulnerable people to be kept in inappropriate settings when they would prefer to be closer to their own communities, rebuilding their lives.

At the British Red Cross we help thousands of patients who no longer require acute care, but who need extra support in order to be able to cope at home, particularly when simply tackling the cooking and cleaning can feel like a daunting challenge.

‘We must all work together to support and properly fund vital community-based services’

This support not only means doctors feel confident about discharging their patients, but also helps build people’s confidence and resilience, reducing the likelihood of yet another hospital admission, and therefore saving even more money.

If the health and social care sector is serious about tackling delayed transfers of care across the board we must all work together to support and properly fund vital community-based services. This will save money in the long run, and also ensure that patients are given the right care, at the right time, and in the right place.

Mike Adamson, British Red Cross, Managing Director of Operations

Emergency stop

Implementing NHS 111 through the ambulance service will seriously compromise its ability to respond to genuine emergencies.

Your article Emergency services feel strain of telephone trial outlines the drastic increase in category A calls for trusts operating the NHS Pathways service. Having worked in emergency dispatch for many years I believe, quite simply, that taking 999 calls through a system devised for out-of-hours or 111 calls is the reason for this increase. 

It has been reported that the system is inappropriately transporting people by ambulance who should be referred to out of hours, which increases the number of ambulances dispatched and puts pressure on ambulances to respond to patients in a genuine emergency within target timeframes.

NHS 111 should not impede on an ambulance service’s job of dispatching emergency ambulances to patients requiring the service.

You report that only eight clinical commissioning groups have sought an extension to the October deadline for NHS 111 rollout plans, but I would urge more to appeal for a delay. We must fully evaluate this data and the concerns of the ambulance service professionals, who clearly perceive a risk to their core operations, to avoid a risk to public safety.

Ron McDaniel, senior vice president, Priority Dispatch