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STPs to adopt care model to tackle bed shortages

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27 November 2017

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NHS England and NHS Improvement are requiring all 44 sustainability and transformation partnerships (STPs) to adopt the Co-ordinated Reallocation of Capacity (CROC) model from January 2018.

The national care method aims to ‘supply the clinical community with optimal equipment and re-allocate sub-optimal to do so’ and tackle bed shortages.

Matthew Cripps, national NHS RightCare director at NHS England, said that ‘we need to maximise value for population’.

Unwarranted variation

NHS England and NHS Improvement are requiring all 44 sustainability and transformation partnerships (STPs) to adopt the Co-ordinated Reallocation of Capacity (CROC) model from January 2018.

The national care method aims to ‘supply the clinical community with optimal equipment and re-allocate sub-optimal to do so’ and tackle bed shortages.

Matthew Cripps, national NHS RightCare director at NHS England, said that ‘we need to maximise value for population’.

Unwarranted variation

He said: ‘Overuse leads to waste and patient harm while underuse leads to failure to prevent disease and inequity.

‘These are unwarranted variations in healthcare.’

The model was inspired by Archie Cochrane, a Scottish camp doctor during WWII, who realised that clinicians often make wrong decisions based on what equipment, drugs and capacity are at their disposal.

It means that if the system supplies, clinicians use what they have, whether it is the optimal treatment for patients.

Tackling bed shortages

There are currently 12,400 unnecessary beds in use across the country, which represents ‘17 full hospitals of people, who shouldn’t be there, every single day’.

By just improving asthma system in the primary and secondary prevention, NHS England was able to reduce the demand for asthma beds by 30% and reallocate the money and beds where they ought to be.

Mr Cripps said: ‘These 30 beds stopped being needed for the unwarranted variation there was in there.

‘You can do that if you co-ordinate it from a panoramic headline view such as in an STP.’

As there is ‘no time to run the pilot for a year’, the outcomes of the model will be assessed through a second wave in April or June 2018 and in a third wave in autumn 2019.

Rob Webster, lead chief executive at West Yorkshire and Harrogate STP, believes that his STP needs such model.

He said: ‘If demand is growing by 4% every year, it means that we need 4% more beds and hospitals as well.

‘If you can turn the curve on that demand because you’re clearer about how you’re designing care, then you can manage with the beds you’ve got and resources.’

  

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