Delayed Transfers of Care (DToC) in Warwickshire: Our journey so far

Our aim

In October 2017, a project began in Warwickshire with one main focus: that fewer patients would be delayed from leaving hospital.

Known as Delayed Transfers of Care (DToCs), the aim was to reduce the number of DToCs so that more patients could get out of hospital and return to their usual place of residence as soon as they were ready to do so ~ and have a better experience of the hospital discharge process along the way.

Work has been taking place to educate staff and patients about the deterioration which can happen if people spend too long in hospital ~ for example, through exposure to infection and lack of exercise ~ and improve communication between the different teams involved in the discharge process.

Too many Delayed Transfers of Care (DToC) can also mean increased costs for health and social care, as more people ultimately end up needing short term medical treatment and ongoing care. So reducing DToCs is good for everyone.

Who worked together?

Warwickshire County Council’s health and social care teams have worked together with staff based at 3 acute, 1 sub-acute and 4 community hospital sites as well as residential, nursing and domiciliary (home) care providers across Warwickshire. Everyone involved has worked positively to introduce new ways of working and trial new initiatives.

This has been against a backdrop of an increase in the number of people presenting to A&E and non-elective admissions of around 6%.

What we have achieved

• There has been a 63% reduction in the number of DToCs in Warwickshire ~ that means 63% fewer hospital beds are occupied by delayed patients (June 2017 to June 2018).
• Staff from different teams are working better together to help patients and customers.
• Patient and customer information is now shared and available to view by both health and social care staff 24/7.
• We have helped more people whilst dealing with an increased demand for hospital beds (around 6%).
• Patients and carers are happier with the discharge process.
• All the partners involved are being more productive and reducing costs.

The Future

The DToC project is being put on hold while the partners involved tackle the expected winter pressures of 2018/19.

The improved communication and partnership working that has resulted so far, and the impact that
this has already had on Delayed Transfers of Care in Warwickshire, has laid solid foundations and puts the county in a good place to deal with the anticipated increase in acute hospital admissions over the coming months.

For more information, contact simonhickman@warwickshire.gov.uk

Download the poster here: WCBT Delayed Transfers of Care (DToC) in Warwickshire – Our journey so far


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