Nottingham North and East Clinical Commissioning Group (NNE CCG) led an innovative initiative to improve the quality of care for patients in a local community hospital.

Evidence showed that many patients could be more effectively managed; an average 37 day length of stay and 46% of patients admitted not meeting the in-patient criteria at some point in their stay. The majority could have been managed in a homecare/community care setting.

The CCG

• Enacted modelling, using Scenario Generator, which suggested with improved community support the same admission activity could be easily maintained with reduced ward capacity
• Worked closely with adult social care to reduce delayed transfers of care which resulted in no delayed transfers of care
• 24 unused community beds were decommissioned
• Enhanced community based rehabilitation support was commissioned for ‘home’ setting as an alternative to staying in Lings Bar harnessing third sector expertise.
• Service redesign and real time evaluation/feedback conducted in partnership with patients and carers has led to the mainstreaming of this model
• Acute trust liaison enabled vacant ward re-utilisation to provide haemodialysis facilities

Outcomes

• Significantly improved experience for rehabilitation and haemodialysis patients
• Recurrent QIPP saving of £1.2m for decommissioned beds
• The haemodialysis unit within the freed-up ward has avoided previously planned £7m new build spend.