STRUCTURE: Oxford University Hospitals trust is planning restructure local services care in a bid to cut delayed discharges.

The local health economy has the highest rate of delayed transfers of care in England.

Trust board papers for July said: “The trust is in the process of redesigning local services, especially in acute medicine, to ‘design out’ unnecessary extended stays in hospital and put in place a model of care that is clinically and financially sustainable.

“This effectively means changing the model of care in particular for vulnerable, older people by offering more integrated care closer to home, applying acute clinical expertise in the non-hospital setting and ‘right-sizing’ OUH’s inpatient capacity.”

The paper points out that this approach will be consistent with Oxfordshire’s local health and wellbeing board priorities.

Among the reforms planned are the establishment of out-of-hospital emergency medical units and early “supported discharge”, as “part of a package of schemes to deliver acute medical care beyond the hospital site, to allow a safe and sustained reduction in the acute bed base”.

The out-of-hospital support will involve “partnership with domiciliary social care to reduce transfers of care, remove fragmentation of care, and eliminate gaps between the boundaries of discrete services”.

The paper says: “The trust will work in partnership with a number of agencies in the local health and social care system, including the third sector, and will contribute to a multi-agency action plan in relation to these shared issues.”

The trust is to explore options for redesigning its secondary care services, “including the introduction of systems that rapidly move patients to relevant speciality care, once their immediate emergency admission needs have been met”.