EH 2_2016

NEWS & MANAGEMENT Continued f Medics urged to organ Shigella in children is being contin- ued throughout 2016. The Netherlands Researchers observed high rates of scabies and its complications among asylum seekers from Ethiopia, Eritrea and Somalia. This repre- sents a considerable burden for the healthcare system, especially where refugee centres already are under considerable strain due to high numbers of new arrivals, the researchers commented. They suggest that scabies must be rigorously controlled in asylum seekers to reduce the risk of compli- cated cases, the strain on healthcare, and to prevent the spread to other patient groups in the proximity of individuals from high-risk countries. Taiwan Surveillance study of tuberculosis among immigrant workers follow- ing pre-entry screening in Taiwan, 2011-2014 identified 2,080 cases of The launch of a novel rehabilitation service bodes well NHS tackles bed blocking crisis Pioneering NHS ‘test beds’ Report: Mark Nicholls Bed blocking is a major problem within NHS hospitals across the UK, with thousands of patients sitting in hos- pital beds facing a ‘delayed discharge’ until the necessary next stage of their care becomes available. A delay may be non-availability of a temporary or permanent space in a residential home, or rehabilitation unit, or a smaller community hospital, or lack of a supportive care package for their return home. The latest figures from England’s National Health Service (NHS) on Delayed Transfers of Care revealed 159,100 delayed days in January 2016 alone, of which 103,500 were in acute care. This is an increase from January 2015, when there were 150,400 total delayed days, of which 103,200 were in acute care. This was also the second highest number of delayed days reported in a month since monthly data was first collected in August 2010. Some 61% of all delays in January 2016 were attributable to the NHS, 32.3% attributable to Social Care and the remaining 6.7% attributable to both NHS and Social Care. The main reason for NHS delays was ‘patients awaiting further non-acute NHS care’ while the main reason for Social Care Test Beds, a term used to describe a technology project resulting from collaborations between the UK’s National Health Service (NHS) and international innovators, aims to har- ness technology to address issues facing patients and the service. The first wave of seven Test Beds was announced last January by NHS CEO Simon Stevens at the World Economic Forum in Davos, Switzerland, who predicted that this will reform the NHS to meet 21st Century challenges - particu- larly from an ageing population and increase in patients with long-term health conditions – while remaining financially sustainable. Frontline health and care workers in seven areas are to evaluate the use of novel combinations of inter- connected devices, such as wearable monitors, data analysis and ways of working that will help patients stay well and monitor their conditions themselves at home. The five NHS Test Beds • Care city innovation – to pro- mote healthy ageing across a million-strong population in North East London. • In the early intervention pro- gramme for long-term condi- tions the NHS in Heywood, Middleton and Rochdale are working with Verily (formerly Google Life Sciences) and other organisations, e.g. the Greater Manchester Academic Health Science Network, to help health- care professionals improve iden- tification and support of at risk patients using advanced new predictive techniques. • In the Lancashire and Cumbria Innovation Alliance (LCIA) the NHS will partner with Philips and several small business and social enterprises to support the frail elderly and people with long-term conditions to remain beyond the hospital and avoid unnecessary admissions. • The PErfect Patient PAthway (PEPPA) test bed aims to create the ‘perfect patient pathway’ for those with long-term conditions, e.g. diabetes, mental health problems, respiratory disease, hypertension and other chronic conditions in the Sheffield City Region. • RAIDPlus integrated mental health urgent care test bed will see Birmingham and Solihull Mental Health NHS Foundation Trust partner with organisa- tions such as Accenture, West Midlands Academic Health Science Network, Birmingham Community Healthcare NHS Trust and West Midlands Ambulance Service and Police to provide more proactive sup- port for those at risk of a mental health crisis. Two further projects – the Internet of Things (IoT) Test Beds • The diabetes digital coach pro- ject, led by the West of England AHSN in partnership with Diabetes UK and technology companies including Hewlett Packard. • In Surrey, Technology Integrated Health Management (TIHM) – a collaboration of a range of health technology providers to help dementia patients to live at home. The test bed programme is part of the NHS Five Year Forward View, published in October 2014, and sees the UK Government and the Academic Health Science Networks (AHSNs), and NHS England working with organisations from across the world deploying and testing various innovations. The Sheffield’s Perfect Patient Pathway test bed includes more than 30 partner organisations; there tech- nology coupled with new ways of delivering care will be used to keep people with long-term conditions well at home, often avoiding hospital admission or further support. A range of home-based monitor- ing devices and smart phone apps will mean patients can be supported to understand their condition and how they can manage at home with data received from the devices being collated and interpreted in an inte- grated intelligence centre. Sir Andrew Cash, Chief Executive of the Sheffield Teaching Hospitals NHS Foundation Trust has observed that ‘The Perfect Patient Pathway test bed is a fantastic way of bring- ing together the region’s health and social care providers with a number of technology as well as research organisations.’ delays was ‘patients awaiting a care package in their own home’. An independent review by Labour peer Lord Carter found nearly one in 10 beds was taken by someone medi- cally fit to be released and that delays in discharging patients from hospital after treatment could be costing the NHS in England £900 million a year. His report described the issue as a ‘major problem’ causing operations to be cancelled and resulting in the NHS paying private hospitals to see patients. Critics say the lack of social care in the community is a key reason why people cannot be discharged from hospital and the latest figures come at a time when spending on social care in the UK has fallen £4.6 billion over the last five years. However, one health charity in the east of England – working with NHS partners - has taken steps to offset this blockage in the system. The Papworth Trust, a char- ity for disabled and older people, has opened a £2 million residential scheme designed to ease the growing bed-blocking crisis in hospitals across the surrounding area. This consists of 28 purpose-built, self-contained flats that will bridge the gap between a hospital stay and discharge by replicat- ing a resident’s home, providing each patient with more than four hours of social care and one-and-a-half hours of occupational therapy daily. The accommodation, to be known as MacFarlane Grieve House, will help residents regain practical skills, confi- dence and independence, while also providing short-term care 24-hours a day. The new rehabilitation service is run on behalf of Cambridgeshire and Peterborough Clinical Commissioning Group (CCG), Cambridgeshire County Council and Uniting Care, with nursing services provided by the Cambridgeshire and Peterborough NHS Foundation Trust. Papworth Trust hopes that the NHS and charities working closer together will introduce the rehabilitation model across the country. Papworth Trust chief executive Vicky McDermott said: ‘MacFarlane Grieve House is a radical new approach to rehabilitation that will save the NHS money, reduce the likelihood of a patient re-presenting at hospital and provides a model that can be rolled out nationally. ‘One of the biggest challenges in our current healthcare system is peo- ple returning to A&E after they have been discharged from hospital with- out appropriate rehabilitation. This is expensive for the NHS and detrimen- tal to the health of every individual who is left vulnerable after acute care. ‘We believe our rehabilitation model will allow hospitals to dis- charge patients into our care, happy in the knowledge that they will receive first-class social care and occupation- al therapy that will enable them to return home and go about day-to-day tasks with improved mobility. This will also mean that hospitals can discharge patients quicker, which will free up more beds.’ Vicky McDermott is chief executive of Papworth Trust, a charity for disabled and older people, which has opened a £2 million residential scheme designed to ease the growing bed-blocking crisis in hospitals Sir Andrew Cash, of the Sheffield Teaching Hospitals NHS Foundation Trust, foresees a uniting of healthcare providers with tech and research groups Des Breen MD, Medical Director for the Working Together Programme believes the test bed idea could potentially revolutionise healthcare delivery Finding out what high-tech can do for home care A ‘technology’ project to modernise healthcare for patients with long- term medical conditions is being trialled in the United Kingdom in seven ‘test bed’ initiatives Mark Nicholls reports © sfam_photo / Shutterstock.com 2 EUROPEAN HOSPITAL  Vol 25 Issue 2/16

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