The Network’s Community Hospitals project is in its fifth iteration and focuses on the core function of community hospitals of bed based rehabilitation of older people.
Community Hospitals are long established in the UK and internationally. High quality evidence supports community hospitals as effective bed based rehabilitation services for older people when compared to general hospitals. The Five Year Forward View outlined an important role for Community Hospitals, and wider community services, in new models of care. The importance of developing care closer to home to alleviate pressure on secondary care and provide the patient centred care has been emphasised by NHS leadership. However, the reality on the ground in 2016 is an increasing number of threatened and actual community hospital closures. In addition to whole hospital closures, this projects shows incremental beds closures within the hospitals that remain open.
The benchmarking project demonstrates the value of Community Hospitals and provides evidence to support their continued role as a key element of service provision for older people and wider local communities.
The NHS Benchmarking Network’s 2016 Community Hospitals project saw 39 organisations participate in the project, covering 179 Community Hospitals. As well as a national report and online toolkit of over 2000 metrics, available to all Network members, bespoke reports will be made available for participants.
Highlights from the 2015/16 audit
- Rehabilitation services / therapies is the core service provided within Community Hospitals and is provided in 96% of the sample. There is wide variation in the selection of other services provided in Community Hospitals.
- The average number of Older People’s Wards is 1.4 and the total number of Older People’s beds shows a mean of 28 (compared to 29 in 2015). 73% of hospitals have no ‘Other Wards’.
- Specific admission criteria are set out in a formal policy or SLA in 93% of Community Hospitals. There is a high level of consistency with all the common admissions criteria suggested in the survey adhered to by more than 75% of respondents.
- The waiting times for a bed within a Community Hospital have decreased from 3.7 days in 2014/15 to 2.6 days in 2015/16.
- The nursing ratio of registered to unregistered nursing staff for 2015/16 is 49.6:50.4, in line with the ratio of 50:50 recommended by the RCN for basic, safe care. The proportion of registered nurses has reduced in each of the last two years of the project.
- In 2016, admissions from acute hospitals account for 42% of admissions to Older People’s Wards compared to 69% in 2015, suggesting a change this year to more capacity being used for step up provision and less for step down.
- Average length of stay on Older People’s Wards has increased from 26.7 days in 2014/15 to 27.6 days in 2015/16.
This project also includes a service user questionnaire that aims to measure outcomes using The Modified Barthel Index score, results are included within the reporting.
The Network’s Steering Group has confirmed that a summarised version of the Community Hospitals project will be included in the Network’s 2017/18 work programme as part of the National Audit of Intermediate Care (NAIC). All Community Hospitals providing intermediate care services in England, Wales and Northern Ireland will be able to participate in NAIC 2017 free of charge.
For more information on this work please contact: