Innovation in out of hospital care implemented across Wales

The Welsh Government NHS Delivery Unit has commissioned work to introduce a new model of ‘Out of Hospital’ care across the whole of Wales, based on a paper published by IPC visiting professor, John Bolton.  The model centres on the principle that every person should have the right to recovery and access to the services to aid that recovery. The uniqueness of the research lies in its tracking individual patient journeys, from hospital through the care system to the end point.

One in five elderly patients are likely to need care and support when discharged from hospital. Often waiting for an assessment or for the right care to be in place, means patients are delayed in hospital. The aim of the recent work by IPC looks to reduce unnecessary delays in hospital discharges and re-shape health and care systems to ensure better outcomes for patients alongside the most cost-efficient methods. 

The range and scale of the problem varies across Wales with differences in the routes patients take following a hospital stay being determined by the health and care system in place in the area. In some cases patients are unnecessarily placed in residential care, owing to a lack of services available to support a person in their home. Clearly this results in a higher long term cost of care, but equally any service that provides an overnight stay of any sort – whether hospital stays or residential care – produces delays in the system as beds become ‘clogged’.  Better outcomes for patients generally mean effective support for their ongoing recovery in their own homes, which also frees up the hospital and residential areas to properly cater for the next tranche of patients. 

The work is being rolled out with a one-day introduction, followed by a period of data collection and a further day of consultancy to interpret the data. To date all the health boards have received the introduction and about half have presented their data and received consultancy around this. This work will help identify those areas with the greater challenges and allow the focus to lie where it’s most needed. 

The work began in the spring, spans approximately six months and aims to introduce this new model to all health boards and local authorities in Wales. Outcomes are being fed back into a steering group comprising Welsh government and NHS representatives and senior civil servants. A report into the findings of this work in Wales will be published on completion. 

Commented IPC Visiting Professor, John Bolton, “This is the most developed out of hospital work in the UK and the results to date are extremely positive. The challenges across Wales vary from location to location. Rhondda Cynon Taf Council has shown the best results in relation to good outcomes for older people, with low delays, and the new model has helped reassure them that they should build on their existing achievements. In Swansea, the Council has already chosen to ask IPC for greater support to help implement change to develop this model and work in ways best suited to overcome their specific challenges.” 

We will be publishing a report around all the findings of this work in Wales in order to take away new learnings and with a view to further enhance the model. 

Email IPC’s Visiting Professor John Bolton to find out more about how IPC supports out of hospital care