Reducing length of stay

The Reducing Length of Stay (RLoS) programme aims to provide patients with a better care experience by ensuring they are discharged from hospital without unnecessary delay.

Prolonged stays in hospital are bad for patients, especially for those who are frail or elderly. Spending a long time in hospital can lead to an increased risk of falling, sleep deprivation, catching infections and sometimes mental and physical deconditioning. Despite this, nearly 350,000 patients spend more than three weeks in acute hospitals each year.

In June 2018, a national ambition was announced by the Secretary of State to lower bed occupancy in hospitals by reducing the number of long stays (21 days or more). This ambition was originally set at a reduction of 25% by December 2018, however this has been extended to a stretch target of 40% by March 2020.

Following this ambition, the RLoS programme was established as a priority within the Emergency and Elective Care (EEC) Directorate to provide strategic direction and support local delivery. Tacking long stays will lead to better patient experience and outcomes as well as increasing capacity within the urgent and emergency care (UEC) system.

By ensuring patients return to their usual place of residence, or another care setting, as soon as it’s safe to do so patient flow will improve right through the system. Beds will be free for those needing quick admission for emergency care or a planned operation, which in turn will have a positive impact on reducing crowding in A&E.

What’s happened so far?

In August 2019, the programme launched the national staff facing campaign, ‘Where best next?’, to help communicate the importance of reducing long lengths of stay. The programme worked with several key stakeholders to establish five principles and specific actions healthcare professionals can take to ensure their patients are discharged in a safe and timely way.

The programme has also supported all acute trusts to implement a Discharge Patient Tracking List (DPTL). The data from the DPTL will provide valuable insight into reasons for delays for patients who remain in hospital for 21 days or more. Using this data will also provide a better understanding of what, and where, further improvements can be made to support delivery of the national ambition.

The guide to reducing long hospital stays webpage offers practical guidance and approaches that can be taken to manage hospital length of stay.

Our focus going forward

The RLoS programme will continue to provide national leadership and support local delivery by focusing on four key areas:

  • Enhanced Clinical Leadership – Clinical champions will be appointed to drive the programme forward and help engage healthcare professionals to support ongoing improvement.
  • Communications and Engagement – Improved communications will ensure there is a strong national message about the importance of reducing length of stays and the positive impact this will have on reducing the risk of patient harm.
  • Improved Intensive Support – The Emergency Care Intensive Support Team (ECIST) will provide advice and guidance to regional colleagues and trusts to support the delivery of the ambition, encouraging implementation of best practice.
  • Research and Evaluation – Better research and evaluation will take place to inform further interventions to reducing length of stays, building an evidence base for improvement and reduction.