With England desperately trying to keep cool during the summer heatwave, the NHS is equally seeking solace in the shade from this summer’s soaring temperatures.
The Met Office has declared an unprecedented red extreme heat warning, with temperatures set to climb above 40C (104F) this week. In issuing its highest warning, the national weather service has set a ‘risk to life’ warning in areas such as London, Manchester and York.
Replicating winter pressures when temperatures plummet, the heat is piling additional pressure on the NHS which is already struggling to grapple with a perennial problem; patient flow.
Patient flow is the movement of patients between hospital departments and other health and care settings as part of an individual’s care pathway. The NHS has long rallied to try and drive up flow efficiency, and minimise the lead time patients experience when moving between institutions.
Poor patient flow essentially means that patients are stuck in a department or setting they clinically no longer need to be in, and is created by a lack of beds or clinical staff in the onward care pathway.
Persistent difficulties with patient flow have been exacerbated by Trusts facing a spike in A&E admissions of vulnerable patients due to the arrival of the sweltering summer. Last week, Health Minister Maria Caulfield set out the scale of the problem, stating that the prolonged impact the heatwave is likely to have for the months ahead on hospitals.
Caulfield and her department face growing calls from ambulance bosses to deliver more hospital beds and care home places to help alleviate patient waiting times.
South Western Ambulance Service NHS Foundation Trust has painted a particularly distressing picture, having lost around 10,000 hours simply waiting to hand over patients in Gloucestershire last week.
The Department of Health and Social Care (DHSC) has pointed to the NHS allocating £150m of additional funding to address pressures on ambulance services. But with temperatures rising and admissions climbing, pressures are now reaching boiling point in one half of the equation.
The second half of the conundrum is safe and timely patient discharge. A lack of adequate care in the community means NHS Trusts are currently finding it increasingly difficult to discharge existing inpatients to free up bed spaces and clinical time.
Two potential solutions are the buzzwords which reverberate around the whole healthcare sector – integration and technology. The long-awaited NHS’ digital health and social care plan has set out an agenda which places digital healthcare technology at the heart of its future delivery, in addition to its face-to-face services.
Former Health Secretary Sajid Javid was keen to stress the benefits of harnessing technology such as remote patient monitoring, virtual wards, and outpatient video consultations, all of which can help patients avoid prolonged and unnecessary hospital stays whilst receiving clinically appropriate care from the comfort of their own home.
The consequences of admitting people to hospital unnecessarily and the failure to swiftly discharge them has led to the current bed blocking experienced by Trusts across the country, the scale of which is staggering.
To realise the Government’s vision for an effective, future-proofed system, it is clear the effective deployment of digital healthcare technology is now mission critical, given the news coming out of Trusts this month.
Liverpool University Hospitals’ Integrated Performance Report has revealed that 290 patients are classified as ready for discharge, but still remain in hospital. The Trust’s board papers published last week revealed how “the Trust continues to struggle to meet the challenge of demand and capacity issues” due to “significant numbers of patients delayed in a hospital setting awaiting ongoing care.”
With around 180 patients that do not have a clinical need to in hospital, Norfolk and Norwich Hospital has attempted to cope with discharge delays in the short-term by opening ‘a home first unit’ at the hospital for patients’ without acute care needs but who have not been successfully discharged.
Warmer weather experienced in this country has prompted society to collectively reconsider its actions to positively contribute to the planet’s sustainability drive. Health and social care will need to ensure it is able to count on a similarly united response to cool the long-term challenges faced by Trusts and improve patient flow, regardless of the temperature’s reading.