Community Health Services Trust, England

06-Jan-2011



Overall length of stay across 12 community hospitals reduced from 35 to 22 days (37%), with resulting savings on excess bed days of £0.9m (2008/09), rising to over £2m the following year. 




Background

Derbyshire County Primary Care Trust (PCT) was formed in 2006 from the amalgamation of six PCTs.  The new PCT became responsible for the management of the county’s 12 community hospitals, with approximately 500 beds (2008/09), providing care closer to home.  Their services include urgent care, rehabilitation, older people’s mental health care, and end of life care.  The change in management structure precipitated a shift in the relationship with the two acute hospitals, with increased emphasis on the reduction of admissions to secondary care.

 

The Trust’s strategy: “A Vision for Better Health and Health Care in Derbyshire” highlighted the significant challenge posed by:

•    A household income that is 60% or less than the national average
•    More people with limiting long-term illness or disability than the national average
•    The number of older people growing at a faster rate than other age groups
•    An increase in the number of falls, fractures and strokes
•    Around 200,000 adults in Derbyshire have a mental health problem at any one time


Results

Overall length of stay across the 12 community hospitals reduced from 35 to 22 days (37%), with resulting savings on excess bed days of £0.9m (2008/09), rising to over £2m the following year. The increased bed capacity provided the Trust with the opportunity to rationalise beds while also meeting national requirements to provide single sex accommodation and side rooms for infected patients, thereby improving service quality and patient experience.


As a result of the released bed capacity, in 2010 the PCT commissioned QFI to develop a bed capacity planning tool, to model retrospective activity by hospital, by HRG, and to project the potential impact of further reductions in length of stay, and marketing opportunities, on future bed capacity.  This has formed a key building block for their business strategy.  Further work in 2010 included a review of Day Hospital Services.

By 2011, the principles of the QFI approach have become a fundamental element of the overall strategy of the Trust and includes the development of an Operational Model for Derbyshire Community Health Services.

 

Testimonial

By working with QFI to apply their Theory of Constraints approach to our discharge processes across all our 12 community hospitals, we have been able to reduce our length of stay by a third within a matter of weeks, and make big improvements to the quality of our patients’ rehabilitation and discharge. The process has developed staff’s confidence in their ability to take control and make changes that improve quality and productivity and has significantly improved multi-agency working across health and social care in Derbyshire.” Tracy Allen, Chief Executive


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