Table 4.12.13
PROVIDER UNITS WITH FCEs/HOSPITAL SPELLS
RATIO GREATER THAN 1.15 IN 1996-97 AND WITH MORE THAN 10,000 FCEs—GENERAL
AND ACUTE
| Position | Provider
| Region | Spells
| FCEs | Ratio |
Position/ratio
in 1995-96 |
| 1 | Aintree Hospitals |
North West | 56,908 | 71,335
| 1.254 | 3 (1.184) |
2
| Royal Liverpool and Broadgreen
| North West | 68,803 | 86,208
| 1.253 | 2 (1.203) |
| 3 | St. Helier's | South Thames
| 30,032 | 37,101 | 1.235
| 1 (1.310) |
| 4 | Royal Cornwall Hospital
| South and West | 51,305 |
61,756 | 1.204 | 37 (1.106)
|
| 5 | Norfolk and Norwich |
Anglia and Oxford | 83,226 | 100,096
| 1.203 | 24 (1.124) |
| 6 | Wirral Hospital |
North West | 69,985 | 84,076
| 1.201 | 94 (1.064) |
| 7 | St. Helens and Knowsley
| North West | 53,940 | 64,539
| 1.196 | 8 (1.154) |
8
| Countess of Chester Hospital
| North West | 38,655 | 45,964
| 1.189 | 8 (1.156) |
| 9 | Milton Keynes General
| Anglia and Oxford | 22,996 |
26,973 | 1.173 | 6 (1.164)
|
10
| Walsall Hospitals
| West Midlands | 36,253 | 42,294
| 1.167 | 31 (1.112) |
| 11 | St Marys Hospital | North Thames
| 20,541 | 23,874 | 1.162
| 16 (1.140) |
| 12 | Addenbrookes | Anglia and Oxford
| 64,683 | 74,618 | 1.154
| 5 (1.166) |
13
| Blackburn Hynd and Ribble
| North West | 51,838 | 59,796
| 1.154 | 7 (1.151) |
14
| Heatherwood and Wrexham
| Anglia and Oxford | 41,614 |
47,988 | 1.153 | 29 (1.114)
|
| 15 | Nottingham University |
Trent | 80,553 | 92,875
| 1.153 | 9 (1.154) |
| | |
| | | |
Footnotes:
1. Data are provisional and ungrossed.
2. Royal United Hospital Bath NHS Trust had a ratio of
3.265 but have been excluded from this table because of incorrect
recording practices. This is being followed up by local performance
managers.
What value does the Department place on the collection of data
on FCEs?
10. The finished consultant episode (FCE) is the standard
measure of hospital inpatient activity; it was introduced in the
1980s following widespread consultation with NHS managers and
clinicians about appropriate measures of consultant workload.
The FCE represents a completed period of inpatient treatment under
the care of an individual hospital consultant and in about 95
per cent of cases represents a complete spell in hospital. It
was considered a better measure of consultant workload than the
previous measure which related to deaths in and discharges from
hospital. FCEs represent a basic count of activity and give no
indication of quality or effectiveness on which the Government
is actively seeking to introduce new, supplementary measures.
11. The number of finished consultant episodes (FCEs)
is not the same as the number of individual patients treated.
In the course of a year the same person may have several hospital
spells, and in any given spell there may be more than one episode.
4.13 AVERAGE DAILY
NUMBER OF
BEDS
Could the Department provide information on 10 year trends
in bed availability and patient throughput for each major hospital
sector and for each Trust? Could information on bed occupancy
(collected for the first time in 1996-97) and occupacy rates also
be included?
Could the Department provide figures for the number of delayed
discharges of patients from acute settings and a commentary on
how these delays are being addressed.
1. Information on 10 year trends in bed availability,
bed and patient throughput in each major hospital sector is shown
in table 4.13.1. Information on bed availability and bed occupancy
for each trust is shown in the publication "Bed Availability
and Occupacy 1996-97, England". A copy of this publication
is provided separately for the Committee.
Delayed Discharges
2. Figures on the number of delayed discharges of patients
from acute settings are shown in table 4.13.2.
3. Established good practice in hospital discharge seeks
to balance the needs and wishes of patients and their carers with
the requirement to make the most effective use of available resources.
While it is in no one's interest for patients to stay in hospital
for longer that they need to, hospital discharge procedures need
to be sensitive to individuals' needs, particularly for older
people. The Government want to encourage this patient centred
approach to all the work done to improve services for people who
may require long-term care. The Government's manifesto made a
commitment to introduce a charter for long-term care which will
set out what people can expect from health, social services and
housing. We will also be issuing further guidance on hospital
discharge procedures, including delayed discharge.
4. In addition, there are many patients who need to be
given the time and opportunity to recover properly from any treatment
they have received in hospital. A period of recovery, integrated
assessment and rehabilitation after major hospital treatment is
crucial for maximising the opportunities for individuals, avoiding
early admission to residential and nursing homes and supporting
people to live safely at home. There is an increasing awareness
of the need for the provision of rehabilitation services and how
they might address the problems presented by delayed discharges
and inappropriate hospital admission.
5. The £269 million funding for the NHS in England,
announced in October was aimed at helping hospitals cope with
medical emergencies, reducing delays in discharging patients and
also reducing the need for people to be admitted to hospital in
the first place.
6. It is crucial that hospital and social services departments
work together to ensure that integrated and sensitive hospital
discharge arrangements are in place for people with long term
care needs. For health authorities and social services departments
to be able to assess need, plan and arrange or provide services
effectively it is important to develop joint information bases
for activity and financial information. In some areas, where progress
has been made in tackling delayed discharge over recent months,
local agencies have identified and shared the data they need to
examine the problem and find solutions.
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