Third of hospital's patients unable to leave as CCGs struggle to fund services

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Thirty per cent of patients in County Hospital unable to be discharged due to a lack of access to community services in south Staffordshire
Sources say commissioners unable to fund community and domiciliary care devices
But CCGs claim financial position is not affecting their ability to fund services
Council says it is not possible to meet national DTOC targets

A trust in the West Midlands is unable to discharge 30 per cent of patients from one of its hospitals as commissioners in the region struggle to fund community services, HSJ has been told.

The patients at Country Hospital in Stafford, run by University Hospitals of North Midlands Trust, are medically fit to be discharged, however sources have told HSJ they have been left waiting because clinical commissioning groups in the south of the county are unable to fund out of hospital services.

In County Hospital, 45 patients are medically fit to be discharged

Staffordshire County Council has also said “with the best will in the world” it will be unable to “immediately” meet national delayed transfer of care targets.

The trust said 45 patients – the equivalent of 30 per cent – in the hospital are medically fit to be discharged.

A source close to the situation told HSJ: “I don’t know a hospital where the number of patients who are medically fit to be discharged is quite so high… it is a particular problem for the [CCGs in south Staffordshire] as there aren’t many community hospital beds to close to fund community and domiciliary care services.”

The source added that there is also a general lack of domiciliary care available for the CCGs to commission “even if they had the money”.

Commissioners in Staffordshire are currently in the capped expenditure programme. The CCGs responsible for the south of the region are: Cannock Chase, South East Staffordshire and Seisdon Peninsula, and Stafford and Surrounds.

National data on delayed transfers of care in July showed UHNM had 1,873 delayed bed days that the NHS was responsible for – the second highest rate in the country.

The news comes as national leaders focus on reducing trusts’ DTOC rates ahead of winter, and more than a third of councils have been asked to reduce DTOCs attributable to social care by more than 50 per cent.

In July, Jeremy Hunt warned local authorities that performing poorly against DTOC targets could have their funding cut.

Alan White, deputy leader and cabinet member for Staffordshire County Council, said: “We have submitted our better care fund submission, including proposals agreed with the CCGs to reduce DTOCs in a safe and manageable way by July 2018.

“Although NHS England has now sought to see national targets hit effectively immediately, with the best will in the world this is simply not possible.

“We have put forward a strong case for our local plans and hope the BCF funding is honoured as we have made it clear that any withholding of money would have a profound impact on health and social care services and the very people the NHS and ourselves wish to help.”

Paul Simpson, interim accountable officer for the three CCGs, said: “The CCGs continue to commission community and home services for patients in County Hospital.

“Neither the CCGs’ financial position nor the CEP has prevented the CCGs from commissioning these types of services.”

Mr Simpson said the CCGs have agreed with the council to fund a discharge to assess programme, based on a model already in place in north Staffordshire, and will also roll out the programme in east Staffordshire this month.

Paula Clark, chief executive of UHNM, said: “We welcome the initiatives from our health and social care partners in expanding community services to improve discharges for patients from County Hospital.”