• NHS England and NHS Improvement rank CCGs on rates of excess bed days
  • According to the data City and Hackney CCG had the highest excess bed day rates in 2017
  • National bodies also published data on excess bed days by medical speciality, which revealed the highest rates were within paediatrics

NHS England and NHS Improvement have compiled a list ranking CCGs across England on their excess bed day rates, HSJ can reveal.

In a letter, sent last week to NHS trusts and clinical commissioning groups, the national bodies asked NHS trusts and CCGs to launch local funding schemes to reduce excess bed days within acute trusts. 

Excess bed days refer to an additional fee paid by CCGs to NHS trusts when a patient stays in hospital for longer than a pre-determined length of time- this varies by each speciality.

In the letter, seen by HSJ, Matthew Swindells national director for operations and information at NHS England and Dr Kathy Mclean medical director for NHS Improvement said: ”Whilst for some patients an extended length of stay will be clinically appropriate, there is significant variation access the country - the highest quartile of CCGs have almost three times the rate of excess bed days compared to those in the lowest quartiles. 

“This indicates that there are opportunities to reduce the length of stay by transferring these patients to a more appropriate setting, including in the community.”

Attached to the letter the national bodies have complied the rates of excess bed days for every CCG in England, between January for December 2017. 

The document also included excess bed day rates by speciality, which revealed the worst rates were in paediatric areas. 

List of 50 CCGs with worst excess bed days per 1000 population (full list attached)

CCG NameExcess bed daysWeighted populationExcess bed days per 1000 weighted population

City and Hackney CCG

26,517

217,080

122.2

Trafford CCG

23,002

255,599

90.0

Manchester CCG

46,861

570,358

82.2

Lewisham CCG

19,781

250,728

78.9

Portsmouth CCG

15,174

203,159

74.7

South Sefton CCG

13,620

189,449

71.9

Dorset CCG

62,622

897,136

69.8

Bath and North East Somerset CCG

13,850

198,603

69.7

Cumbria CCG

26,023

381,336

68.2

West Hampshire CCG

40,777

602,187

67.7

Nene CCG

42,067

651,154

64.6

Lancashire North CCG

28,491

443,878

64.2

Southampton CCG

15,743

264,745

59.5

East Lancashire CCG

25,974

442,508

58.7

Fareham and Gosport CCG

12,521

214,680

58.3

Leeds CCG

47,638

841,070

56.6

Dartford, Gravesham and Swanley CCG

13,854

253,318

54.7

South Eastern Hampshire CCG

12,342

226,776

54.4

North Hampshire CCG

11,913

219,566

54.3

North East Hampshire and Farnham CCG

11,873

219,039

54.2

Oxfordshire CCG

34,264

635,244

53.9

Buckinghamshire CCG

26,687

496,338

53.8

Sutton CCG

9,286

178,215

52.1

Cannock Chase CCG

8,093

155,613

52.0

Corby CCG

3,961

76,311

51.9

Surrey Heath CCG

4,900

95,014

51.6

Doncaster CCG

18,298

361,467

50.6

Stockport CCG

18,131

359,726

50.4

Fylde & Wyre CCG

9,703

196,564

49.4

Swindon CCG

10,431

212,607

49.1

Norwich CCG

10,624

219,904

48.3

Somerset CCG

31,515

652,509

48.3

Tameside and Glossop CCG

13,772

285,253

48.3

Wiltshire CCG

25,080

521,815

48.1

Bexley CCG

10,783

231,344

46.6

Greenwich CCG

11,064

238,883

46.3

Blackburn with Darwen CCG

8,780

190,599

46.1

Herefordshire CCG

9,244

202,417

45.7

North Norfolk CCG

9,653

211,415

45.7

West Leicestershire CCG

17,059

373,722

45.6

West Kent CCG

21,099

466,097

45.3

East Surrey CCG

8,031

177,628

45.2

Eastbourne, Hailsham and Seaford CCG

10,297

229,883

44.8

Surrey Downs CCG

12,813

287,086

44.6

Lambeth CCG

12,333

279,652

44.1

Ealing CCG

14,725

335,225

43.9

Sheffield CCG

25,691

588,192

43.7

Bromley CCG

14,081

325,636

43.2

Newcastle Gateshead CCG

24,591

573,862

42.9

All CCGs

2,220,166

58,719,921

37.8

List of 25 specialities with worst excess bed day rate as a proportion of all inpatient days (full list attached)

SpecialityTotal bed daysExcess bed daysExcess bed days as a proportion of all inpatient bed days

Paediatric Immune System Disorders

1,731

1,106

64%

Eyes and Periorbita Procedures and Disorders

96,841

23,429

24%

Pain Management

1,371

274

20%

Paediatric Nervous System Disorders

70,126

13,035

19%

Paediatric Non-Malignant Haematological Disorders

21,982

3,795

17%

Paediatric Rheumatology Disorders

23,642

4,049

17%

Paediatric Gastroenterology Disorders

119,025

19,854

17%

Skin Procedures

60,807

10,112

17%

Ear, Nose, Mouth, Throat and Neck Disorders

346,181

57,235

17%

Paediatric Diabetology, Endocrinology and Metabolic Disorders

26,071

4,200

16%

Paediatric Hepatobiliary Disorders

6,623

937

14%

Spinal Procedures and Disorders

683,256

95,454

14%

Poisoning, Toxic Effects, Special Examinations, Screening and Other Healthcare Contacts

956,443

129,901

14%

Paediatric Cardiology Disorders

26,991

3,478

13%

Paediatric Haematological-Oncology Disorders

67,756

8,104

12%

Musculoskeletal and Rheumatological Disorders

688,994

80,579

12%

Diabetic Medicine

209,172

24,189

12%

Neurological Imaging Interventions

36,156

4,157

11%

Paediatric Medicine

139,142

15,918

11%

Haematological Procedures and Disorders

608,126

61,917

10%

Nervous System Procedures and Disorders

2,991,163

302,863

10%

Paediatric Ear Nose and Throat Disorders

50,630

5,084

10%

Orthopaedic Disorders

833,615

83,338

10%

Ear, Nose, Mouth, Throat and Neck Procedures

176,954

17,354

10%

Paediatric Renal Disorders

24,532

2,392

10%

 A spokesman for City and Hackney CCG said: “Closely working with all partners, City and Hackney Clinical Commissioning Group has reduced the numbers of excessive days by over 40% in the last year. This improvement continues through the joined up work of our Integrated Discharge Service and Integrated Independence Team who help ensure our residents transition from hospital to their homes with the right support.” 

Story updated 14:17 with comment from City and Hackney CCG.