By Mark Hutchinson, VP Healthcare Strategy and Transformation

In January 2024, Accident & Emergency Departments experienced their busiest month ever, resulting in a significant increase in extended waiting times, reaching some of the highest levels ever recorded1. In certain areas, some patients endured waits of more than 10 hours while still in ambulances2.

Delays in discharges and capacity issues across Integrated Care Systems (ICS) contribute to overcrowding and prolonged waits in A&E Departments. Patients can be found waiting on trolleys in corridors for treatment or outside in ambulances.

And, in many cases, patients are stuck occupying beds while awaiting discharge to either their homes or appropriate community providers after their treatment. These beds would otherwise be available for patients with other pressing care needs. It doesn’t have to be this way, though.

Let’s explore how a strategic approach can enable a faster coordination of patient movement and discharges, transforming patient flow and enhancing overall system performance.

Unravelling the complexity

The intricate web of technologies, data systems and services within an ICS is the product of a long history of separate organisations working independently. The challenge of merging these disparate entities is incredibly complex. And with it, there also comes a cost. Building or purchasing additional modules might solve immediate challenges, but it often leads to increased expense while stifling innovation.

How does this affect patient flow?

· Managing complex healthcare data: Many care providers across an ICS often run in silos and use multiple EPR systems, spreadsheets and manual processes to manage patient flow within the ICS.

· Access to information: Lack of data visibility for ICS patient flow teams can lead to delays in patient discharges and movements across the system.

· Operational efficiency: A lot of time is often wasted confirming the status of patients as often no joined-up approach is in place for transferring people between organisations.

Increased risks

The diversity of technology, systems and data directly contributes to increased clinical and operational risks. Getting clinical colleagues across different hospitals to agree on standardised processes is a crucial step in reducing clinical and operational risks. Having a single source of truth where all partners across an ICS from all care settings—including acute, community, mental health and social care—can access the same data seamlessly is likely the logical next step.

The reality

There is currently great demand on the NHS from acute and non-acute/planned pressures that will only continue. This breakdown started years ago with an increase in pressures in the community. Patient flow teams have poor visibility into why patients are not being discharged or transferred to the next stage in their care and cannot easily identify where free beds are available.

Better visibility

Many organisations find it difficult to plan and coordinate patient discharges, and need a way to ensure patients transition through the continuum of care with as much ease as possible. Care providers in an ICS need tools to improve efficiency and optimise system-wide bed utilisation.

Want to learn more?

Meet the team on stand B30 at Digital Health Rewired on 12–13 March, and we will share more about how the new Altera ICS OCM solution is enabling all care providers in an ICS to understand the status of patients in their care, giving visibility to bottlenecks and prompting action and faster coordination of patient movement.