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Concern reduction in delayed transfers of care has 'hit a wall'

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Delayed transfers of care from hospital fell slightly in March, with more than half of councils now below the government’s benchmark for delays attributable to social care.

The latest figures, published by NHS England last Thursday, showed system-wide performance on delayed transfers improved by 0.18% compared to February, when delays increased by 1.7%.

There was a 2% increase in emergency admissions in March compared to the same period last year. In January there was a 7% increase and in February the comparative rise was 5%.

Delayed transfers attributable to the NHS increased by 2.3% in March, while those due to social care fell by 4.3%.

The figures show 117 of 151 councils have now improved on their delayed transfers performance since February 2017, which was the baseline used by the government for targets set last July as part of the better care fund (BCF) planning guidance.

A total of 69 councils hit the BCF target, while 81 operated above the overall government target rate of 2.6 days attributable to social care per 100,000 of the population, which is the social care component of an overall delayed transfer target rate of 9.6. This is an increase from 63 councils in February.

In March, there were 18 areas where the overall delayed transfers rate of 9.6 has never been met and performance has continued to deteriorate. This is down from 21 areas in February.

Impower health director Sarah Atkinson said while there had been a significant decrease in delayed transfers over the past year, the modest improvement in March shows the scope for further improvement is limited.

She said: “We have hit a wall. We are still slightly below the numbers in December and I don’t think we can say that is just about winter.

“Investing even more money and energy in DTOC (delayed transfers of care) at this point in time is delivering diminishing returns. We need a different approach.”

Ms Atkinson added the government’s target for overall delayed transfers is unrealistic unless more time and resources are focused on preventing emergency admissions to hospital.

“We are missing a trick by putting all our reablement and homecare services at the back door of the hospital whereas in reality, shifting that to avoid people coming into hospital in the first place is not only the right thing to do it is far more effective from an organisational perspective,” she said.

Responding to the figures, chair of the Local Government Association’s community wellbeing board Izzi Seccombe (Con) said it was a “fantastic achievement” that delayed transfers of care attributable to social care had fallen to their lowest level since September 2015.

She added: “Councils are keen to continue to liaise with their NHS partners locally but need urgent funding to invest in effective prevention work to reduce the need for people to be admitted to hospital in the first place.

“Government needs to address immediate pressures impacting on the system today as part of the funding gap in adult social care which is set to exceed £2bn by 2020 and ensure its green paper delivers a water-tight solution to the long-term sustainability of the sector.”

To see how individual local authorities are performing on delayed transfers of care, or to look at DTOC days and emergency admissions in your local health trust, click here to download Impower’s index.

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