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Deteriorating transfers of care ‘fast becoming biggest problem’ for trusts

There were over 153,000 days of delayed transfers of care in just one month last year, the second highest figure ever recorded since data was first collected in 2010, the latest NHS England statistics for November 2015 show.

The figure was nearly 8% worse than the amount of delayed days in the same period in 2014. On the last Thursday of November, the numbers were at their all-time worst.

The statistics also highlighted a number of other missed targets across the health service, including in A&E waiting times, ambulance response times and waits for cancer treatment – but the Nuffield Trust said delayed transfers were “of particular concern”.

“The number of delayed days in November was not quite as high as the peak reached the previous month, but is still the second highest since collection of the data began five years ago,” Nigel Edwards, the think tank’s chief executive, said.

“And although the number of patients delayed is only a snapshot taken at one point in the month, this was still the highest number recorded since recording began. Everyone agrees that hospital is not the best place for most of these patients once their medical treatment is finished – the issue of delayed transfers is fast becoming the biggest problem many NHS trusts are facing.”

The government has already indicated its awareness of the growing issue of delayed transfers in the health service, and has decided to require local areas to develop action plans designed to manage these high levels of delays.

But the think tank argued that the many other missed targets were also particularly worrying considering they only accounted for the month of November, when the weather was “exceptionally mild and winter had not even properly begun”.

“The fact that there have been such dips in performance so early in the season does not leave the health service in a good position to cope with the rest of winter,” Edwards said.

Data for ambulance response times represented the sixth month in a row in which the standard of 75% of Red 1 calls being responded to within 8 minutes was not met. When considering Red 2 calls, the standard has not been met since January of 2014 and, within Category A calls, standards were not met in the last eight months.

The amount of patients admitted, transferred or discharged from A&E within four hours was below the 95% standard at 91.4% - considerably lower than the same month last year (93.5%) despite attendances being just 1.1% higher.

Edwards continued: “The fact that so many targets – not just on A&E waits but also on ambulance response times and waits for cancer treatment – are now routinely being missed every month lays to rest the idea that a few poorly performing trusts are dragging down the rest.

“Failure to meet the targets now seems to have become the norm rather than the exception.”

But Richard Barker, interim national director of commissioning operators for NHS England, claimed the performance needed to be assessed against the context of rising demand.

“These figures for last November show frontline staff treating record numbers of patients, with particularly large increases in the number of patients getting diagnostic tests, emergency ambulance callouts, and using the NHS 111 service,” he added.

“We continue to treat more than nine out of 10 patients A&E patients within four hours, probably the best performance of any major western country.”