Integrated Care & Social Care

16.03.17

Integrated ‘streaming’ service to be introduced in all hospitals by Christmas

NHS England has set a goal for all hospitals with an A&E department in England to have a “comprehensive front door streaming” service in place by next Christmas.

The streaming service aims to make care more efficient and take pressure away from emergency departments by having a primary healthcare professional “stream” patients coming through hospital doors, who can then refer them to primary healthcare or an emergency department.

The scheme is already successfully in place in Luton and Dunstable hospital, which is one of the best-performing emergency departments in the country, as well as a handful of other hospitals – and it is hoped that the idea could drive efficiencies in the whole of the NHS.

Around 50 to 100 hospitals will required remedial work or extra bed capacity creation to be able to put the service in place across all 44 of England’s STP footprints.

The news was announced by NHS England CEO Simon Stevens at a Public Accounts Committee hearing about GPs, during which he said: “We are setting a requirement that all hospitals have GP streaming in place by this coming Christmas. Our assessment of the incremental capital required to do that is consistent with the funding we got from the chancellor [at the Spring Budget].

“Obviously, without glossing over it, this is only a part of the solution. There are a set of other things that need to change as well, and possibly the most important will be using the extra social care support to ensure that frail older people are able to leave hospital.”

He also emphasised the importance of streaming to making space in crowded hospitals, arguing: “If we can free up 2,000 to 3,000 hospital beds that at the moment are out of action, that is the equivalent of opening five new hospitals across England.”

The CEO of NHS England added that plans for streaming care were already some way down the line with most STPs, explaining: “STPs have already developed their outline proposals, and in a number of cases those are quite well advanced.

This is £325m over three years, so that will enable us to kick-start some of these but is not obviously the whole proposition.”

During the hearing, Stevens said he welcomed the chancellor’s Budget announcements, which will be a way of “kick-starting a turnaround in A&E performance, so that the NHS goes into next winter in a better position than we faced this past winter”.

“In order to do that, we have to help at the front end of hospital A&E departments and at the back end in terms of delayed discharges for frail older patients,” he added. “The chancellor’s announcement is for both.

“Obviously, the £100m capital is to help ensure that A&E departments can make the space available to put in place GP streaming on the model that has been successfully adopted in places like Luton and Dunstable hospital, one of our top-performing A&E departments in the country, and have that in place by next Christmas.

“On the back end, with the extra £1bn for adult social care, as the chancellor said yesterday, it will be very important that councils use that to help reduce the number of blocked beds.”

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