Health boards will take action to increase the number of beds available for critically ill patients by tackling delayed transfers of care, Health Minister Mark Drakeford announced today (Tuesday July 22).
Up to 14 beds a year are being lost because of high levels of delayed transfers of care from critical care units, two reports which are published today show.
A new developmental measure will be piloted across Wales from the autumn, which will require health boards to reduce the number of hours lost because of delayed transfers by 10% every quarter.
The two reports – the first annual report for the critically ill and an assessment of the unmet need for critical care in Wales – present an overview of NHS performance and identify other steps health boards need to take to improve care for patients.
They also highlight important initiatives already in place, which have helped to improve the care patients receive and ultimately drive up survival rates.
Key finding from the report include:
- Survival rates are improving – the number of patients being transferred back to a ward after being admitted to a critical care unit is increasing. In 2012, just over 80% of patients were discharged to another ward, up from 79% in 2011;
- The NHS is meeting the demand for critical care, which has been slowly increasing over time. In 2011 there were 8,991 admissions and in 2012 there were 9,887 admissions – an increase of almost 10%;
- Readmissions to critical care within 48 hours are very low – less than 2% of all discharges, indicating ward-based care and the discharge process are effective;
The Intensive Care Society’s carers’ feedback questionnaire has been introduced to obtain the views of carers. Hospitals which have taken part have reported excellent satisfaction rates on communication, facilities and medical and nursing staff.
But both reports show the NHS must focus on reducing delayed transfers of care from critical care units in Wales and ensure all admissions are appropriate and in patients’ best interests to make best use of existing beds before investing in additional capacity.
The assessment of unmet need for critical care report concludes that Wales may need another 73 critical care beds. However, both it and the annual report highlight the problem Wales currently experiences with delayed transfers from critical care units, which can result in the loss of up to 14 beds a year.
The assessment report also says that until the rate of delayed transfers is reduced, creating additional capacity is unlikely to alleviate the problem.
The annual report also says it may be appropriate to concentrate critical care services in fewer hospitals than they are currently provided. This might mean bringing together intensive care services – level three care – but ensuring other hospitals maintain the facilities to resuscitate and stabilise critically ill patients before they can be transferred to an intensive care unit.
Health Minister Mark Drakeford said:
“Across Wales, the NHS provides good quality critical care services and has a committed workforce. All health boards have developed and are implementing robust delivery plans supported and developed by clinicians.
“However, critical care beds are not always used appropriately. For example, not all patients in critical care beds need that intense level of care and some patients in critical care beds may be waiting to be transferred to a normal hospital ward for ongoing care and support.
“We must make the best use of the resources we already have and action must be accelerated to tackle inefficient use of our critical care beds. All health boards in Wales should have a plan in place to do tackle delayed transfers of care and will be required to deliver a phased reduction. This will require co-operation and co-ordination across the hospital.
“Wales’ critical care beds are spread over a large number of hospitals but there is a growing consensus of opinion among clinicians that they may be better be concentrated on fewer sites.”
The first annual report on critical care services is available here:
http://wales.gov.uk/topics/health/publications/health/strategies/delivery-plan/?lang=en
