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Growing disparity in delayed transfer of care figures

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Overall levels of delayed transfers of care from hospital increased in February for the second month in a row after six months of reductions, with performance in 21 areas where the government’s target has never been met continuing to deteriorate.

The latest figures, published last Thursday, show system-wide performance on delayed transfers worsened by 1.7% in February 2018, at a time when emergency admissions rose by 5% on the same time last year.

Delays attributable to the NHS grew nationally by 1.9% during this period, while those attributable to social care increased by 0.25%.

The figures show 117 of 151 councils have 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.

This was a very slight improvement in performance on the previous month, when 115 councils had done so.

However, only 65 of councils which are continuing to improve met the BCF government target in February.

Of these, 63 also 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.

Since February 2017, overall delayed transfers have fallen by 25%. Those attributable to social care have decreased by 34%, while those due to the NHS have fallen by 19%.

Impower health director Sarah Atkinson said the data shows good area systems have experienced a dip in performance which is likely to be the result of winter pressures, but could also be due to the “limits of what can been achieved” due to pressures in the system.

She said: “There is a tenfold variation in the best performing areas and the worst performing areas, which is massive and unacceptable. There is plenty to be learned from those areas that are performing well.”

Ms Atkinson added the 21 worst performing areas are likely to have structural issues, including limited capacity in community settings which can take a long time to address.

She said: “We need to address demand earlier. We are still out of control on emergency admissions.

“Potentially by freeing up beds in terms of managing [delayed transfers], we are just creating more capacity to manage demand and it all becomes completely overwhelming.”

Chair of the Local Government Association’s community wellbeing board Izzi Seccombe (Con) said the figures show councils have minimised increases in delays during a challenging period.

“If delayed transfers of care and pressures on the NHS are to be reduced, it’s imperative that adult social care is seen as an essential service in its own right, given parity with the health service and fully funded to future-proof it for the rising numbers of people who need care,” she said.

“The government needs to give urgent funding to councils to invest in effective prevention work to reduce the need for people to be admitted to hospital in the first place, which will help to reduce costs to the public purse.”


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