Comment / Discharge duty

If your health systems are like mine, you will be experiencing very high numbers of patients accessing urgent care. Our emergency departments are busier than ever, primary care colleagues are experiencing huge demand and the words ‘but it’s only May’ have been ringing out wherever I go.

We are also trying to provide as much elective care as possible to try to clear enormous waiting lists.

And you’ll be watching what’s happening in those areas with higher numbers of people with the most recent Covid variant to see whether hospital admissions are rising. 

In my part of London, we are still working on getting vaccination rates up in the general population and in our hospital staff groups. It feels busier than ever, and so important to get the balance of these competing priorities right. Our workforce is tired and scarce – we can’t do everything, and we must treat each other with kindness and care!

I’ve been thinking about what’s worked particularly well over the last year. I wanted to write about the discharge funds that were provided to help move patients from hospital beds to more appropriate care settings without getting stuck in a bureaucratic funding nightmare.

That funding significantly helped reduce unnecessary hospital stays and arguably will have helped more patients get back to independence as a result.

I hope that most care systems will be easily able to describe the benefits – and the improved relationships between social and health care as we stopped having non-value-adding arguments about doing the right thing for patients.

It’s great that six months of this funding was allocated this year, but what happens after that? It really needs to get backed into the permanent central allocation to prevent us sliding back to pre-Covid, prehistoric times. 

And of course, I can’t write about discharge from hospital arrangements without pointing out the heart-breaking omission of social care plans from the Queen’s speech.

Great news about the extra funding for health, but after the year we’ve had, and the new status of integrated care systems, we can’t avoid the tricky issue of social care reform and finance.  Health and social care are inextricably linked and we have to face up to that.

We’ve held some really good roundtables recently at the HFMA. In this issue, we report on one looking at the system finance framework. But I had the pleasure of chairing a session with Health Education England talking about how we can get new technologies to really drive value. 

We heard from a range of clinical and finance leaders about what was happening in their organisations and systems, and about some of the challenges of both defining and extracting benefits. We also discussed the cultural challenge. New tech and innovation doesn’t just land – we are human beings and we need help adjusting!

While this is hard, it shouldn’t stop us making progress in this space, and I’d encourage you to have a look at the write-up if you haven’t already (hfma.to/may216). Hopefully it will resonate and you will find a way to really innovate in your own areas.

It’s final accounts time, and I see my finance team working their socks off to close another extraordinary year. I want to pay my respects to my old colleagues for how they have got their heads down to deal with last year and simultaneously set the operating plans for 2021/22. A year like no other, in many senses. Thank you to each and every person who is involved in both mammoth efforts.

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