acuity accounting

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acuity accounting

The diagram above (Figure 1) shows a simplified version of the flow of patients through the hospital system. An arrow of admissions rate flows into the total stock of patients meeting the criteria to reside in hospital. A further £490 million was allocated for the period between October 2021 and March 2022 to cover up to 4 weeks of funded care until 31 March 2022. From 1 September 2020 to 31 March 2021, government funding of £588 million was in place to provide funded support packages of care and rehabilitation for individuals with new care requirements on discharge from hospital. The funding model provided up to 6 weeks of centrally funded care for new or additional needs on discharge from hospital.

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acuity accounting

In addition to the £500 million discharge fund, a further £200 million discharge fund was announced on 9 January 2023. This fund supported discharging patients from hospital beds into step down beds to improve patient care and system flow. There are 2 broad approaches for estimating the counterfactual used in this analysis.

Thematic analysis methodology

Alongside workforce capacity, local areas reported difficulty in securing bed capacity due to insufficient availability in the market as well as competition for beds, particularly in smaller areas. Some local areas experienced unwillingness from providers to accept short-term admissions. They also noted long waits for complex cases and specialist care, most notably for young people, mental health and substance abuse cases. The template included an expenditure sheet and scheme types that focused on spend that was relevant to the funding, and additional expenditure categories related specifically to recruitment and retention of the social care workforce.

  • The details of the £500 million discharge fund were published 17 November 2022.
  • We also signed up for demos, reached out to customer service reps and read verified reviews on third-party sites like Gartner Peer Insights to ensure our review reflected multiple user perspectives.
  • NCTR then stabilised, before a dip between Christmas and new year, before increasing to a peak on 11 January 2023.
  • In addition to the £500 million discharge fund, a further £200 million discharge fund was announced on 9 January 2023.
  • Every hospitalised patient’s criteria to reside are reviewed daily to determine the rationale for their continued acute hospitalisation.
  • Some local areas also said that, due to challenging work and living circumstances, staff were often prioritising time off and rest over taking on overtime or additional hours.

During the data familiarisation stage (see Table 8 below), repetition was observed in the weekly responses. This is likely due to the frequency of monitoring submissions or an overlap in question topics. It was found that the responses with the most detail occurred in the first 2 waves and, after this, non-response and repetition increased. Responses to the open-text fortnightly monitoring questions were analysed using thematic analysis. Thematic analysis is a widely used technique to systematically identify key themes and subthemes in the data. Due to these challenges, the approach for the impact analysis relied on implementing multiple estimators with varying assumptions.

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Finding specialist staff able to manage patients with complex needs was particularly challenging. Funding timelines meant that, since areas were unable to offer full-time positions, filling short-term vacancies was difficult. Timelines also limited the process for securing international recruitment licences. Finally, some local areas said they used the fund to support business-as-usual activity and did not necessarily take forward new initiatives. The fund instead enabled them to support service recovery considering increased expenses in previous years. Workforce was the largest area of spend (£107 million) across local areas, followed by home or domiciliary care (£97 million) and intermediate bed-based care (£95 million).

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  • Figure 15 above compares a 7-day rolling average of actual NCTR at England level against an approximation of what NCTR would be without the missing submissions.
  • It is also difficult to make consistent comparisons as the pressures seen in 2020 and 2021 are not comparable to a normal winter.
  • More detail can be found in the ‘Further details on impact analysis data’ section of the annexes.
  • Figure 13 above shows that the number of general and acute (G&A) beds available in all acute trusts increased over the winter of 2022 and was slightly higher in April 2023 compared to a year previously (around 92,711 compared to 90,991).

This included mental health support, support for carers (unpaid and paid), transport, short-stay wards, additional domiciliary care or visits, grants for patients and/or carers, and working with patient support charities and volunteers. The intention was to free up hospital beds as well as to help to retain and recruit more care workers. This was in the context of increasing numbers of patients being in hospital each day who no longer met the criteria to reside over 2022.

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