Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what criteria his Department uses to monitor the adoption by NHS hospitals of good practice to enable (a) appropriate patient flow, (b) timely hand-offs between A&E clinicians and acute physicians, (c) discharge to assess, (d) trusted assessor arrangements, (e) streamlined continuing healthcare processes and (f) seven-day discharge capabilities.

Monitoring of performance against the 95% four hour accident and emergency standard, along with data regarding 12 hour waits for admission, bed occupancy and delayed transfers of care is collected and published monthly by NHS England. Data, published at both a national and a trust level, is available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/

Discharge to Assess and Trusted Assessor arrangements are both monitored by the Better Care Fund (BCF) partners. This is supported by the BCF quarterly reports that are submitted by Health and Wellbeing Boards to NHS England as part of the policy framework and planning requirements for 2017-19.

From 2015-16, NHS Continuing Healthcare has been included in the assurance processes for clinical commissioning groups. For individuals on the acute hospital discharge pathway, NHS England has introduced a Quality Premium to incentivise assessment for NHS Continuing Healthcare in a community setting where appropriate.

NHS Improvement’s good practice guide, ‘Focus on improving patient flow for national priorities for acute hospitals 2017’, published in July 2017, set out six principles underpinning good patient flow including the principle that flow is seven days a week. Attendances and admissions occur relatively consistently through the week and so should reviews, transitions and discharges. The document can be accessed at the following link:

https://improvement.nhs.uk/resources/good-practice-guide-focus-on-improving-patient-flow/