NHS Lothian and Edinburgh Health and Social Care Partnership – Adults with Incapacity (AWI) pilot saves £1 million per year
In March 2016, 253 patients across Scotland had their discharge from hospital delayed because they were waiting for a welfare guardian to be appointed; 24 of these were within the City of Edinburgh Council area.
In order to address this challenge for services, the following month the City of Edinburgh Council, NHS Lothian and the Scottish Government met to agree a plan to reduce the numbers and length of stay of those patients going through the guardianship process. Subsequently, the Scottish Government and NHS Lothian approved funding for the City of Edinburgh Council to appoint two Mental Health Officers posts to aim to reduce the numbers in this category. Total staff costs were approximately £100,000 per year.
The ihub’s Evidence and Evaluation for Improvement Team (EEvIT) provided support to evaluate the impact of this change. The evaluation process demonstrated that the AWI pilot was a success – the new team and process facilitated a reduction in the numbers of individuals delayed (from 28 to 9) and associated length of stay of delayed patients (3,605 bed days to 827 from April 2016 to March 2017). The positive impact on individuals and their families from reducing unnecessary time spent in hospital, with all the associated distress, was significant. While the number of people delayed may be relatively small, the delays were some of the longest in Edinburgh. Based on the reduction in patients waiting each week and the associated cost per week of an inpatient stay, the AWI pilot represents an efficiency gain in excess of £1 million per year.