Lack of hospital beds sees patients sent ‘out of area’

A lack of hospital beds means some patients are being sent “out of area” by an NHS trust.

Eight Herefordshire and Worcestershire Health and Care NHS Trust patients were receiving care “inappropriately out of area” at the end of December.

That number was 16 at the end of November, compared to a target of zero.

NHS England describes inappropriate out of area placements as being where patients are sent elsewhere because no bed is available for them locally.

It says this is associated with poor patient experience and outcomes.

Matthew Hall, chief operating officer at the health and care trust, said ‘out of area’ doesn’t necessarily refer to patients being moved out of the county – some will be in non-NHS hospitals.

“We’re around the middle of the pack in the Midlands,” he said. “If you went back a year ago, you’d have providers with 100-200 out of area placements.

“There’s been a lot of good work about bringing local providers onto assurance frameworks to provide additional beds to agreed standards.

“The reasons we’ve been struggling to get down to zero are well understood – they’re around long length of stay for a cohort of patients.”

In his report to the trust’s January board meeting, Mr Hall said: “The NHS England national target length of stay for acute mental health adult inpatients is 32 days.

“Currently 29 working age adult patients have lengths of stay in excess of the 60 days ‘long length of stay’ NHSE reporting threshold – 49% of working age adult acute capacity.

“Of those 29 patients – 12 have a stay of over 150 days (three over 300 days).

“This creates an unsustainable situation, where all admissions are managed with only half the bed base effectively available.”

He told the meeting on Thursday (January 23): “In all honesty we’re managing our beds very well. We don’t have a queue of patients waiting to come in, for most of the time.

“We have agreed with the ICB that we should accredit some good quality local provision to provide some additional capacity, maybe 10 beds, while we’re working through longer term sustainable plans.”

He added that the trust cannot work with providers rated inadequate by the CQC and is working with two providers in Worcestershire and one in south Birmingham.

Mr Hall was asked if a lack of community healthcare was an issue affecting long stays in hospital.

He said it “remains an issue” and that the trust is working with housing providers.