Unblock those beds
The intelligent and helpful folks at McKinsey gathered some stats to help us better understand the problem of bed blocking (thanks guys)
At least once a week there’s a news story in the UK about the costs and delays to treatments resulting from bed blocking. I’m pretty sure it’s the same in every country with a public health service.
If we look at the data for England DTOC (Delayed Transfers of Care) there are numerous reasons for blocking:
- Awaiting a complete assessment
- Awaiting funding
- Awaiting further non-acute care
- Awaiting residential home placement
- Awaiting nursing home placement
- Awaiting home care package
- Awaiting community equipment and adaptations
- Patient or family choice to remain
But lets focus on 4, 5 and 6 above, i.e. blocking caused by a lack of capacity or resources down the line.
If you analyse the residential and nursing home situations, they have similar problems – they can’t free up space because the next “lower” tier of care has no capacity, or the patients home environment does not meet their current needs.
And what’s not shown in the full list is DTOC resulting from the need for simple regular checks (BP, temperature, quick conversation to ensure that patient is feeling ok, not in pain etc). These are checks that could be carried out remotely using the latest generation of Bluetooth enabled BP cuffs, pulse-oximeters etc, paired with a Kraydel device which would also allow a live video call to supervise the check and to discuss any other matters.
In the year 2016-2017, there were 992,000 bed blocked days in England for reasons 4, 5 and 6. The mind boggles at the thought of that much lost capacity. Based on current estimates of the cost per day in hospital (£400) that’s £350M of waste. Our guess for the UK as a whole – over half a billion pounds per year lost.
Let’s suppose that using Kraydel to make the home environment safe for a discharged patient by providing remote monitoring and video check-ups, could reduce this by 10%. That’s £50M saved per year.
The cost of long term residential care is currently £716 per week on average, and for long term nursing case it’s £596. If we could get 10% of those people back home, that’s another £80M saved annually for England, or say £100M annual saving for UK as a whole.
These are likely underestimates – if we were to shave an average of 1 day off each stay, the savings would be huge.
And finally, one week of avoided long term nursing would pay for a Kraydel device and service for over 1.5 years.
There is a huge financial win here if we succeed in this. But it’s not just the money – those same patients don’t want to be in a hospital bed, or in a care home, they want their independence back and to be in their own homes. Let’s make it happen.