AROUND 20,000 critical care ‘bed hours’ in Gwent hospitals were lost in 10 months because patients deemed well enough for transfer could not be found beds on wards, or be moved early enough.

Health board bosses are implementing an action plan to manage the demand on critical care units at the Royal Gwent and Nevill Hall hospitals.

In Wales, a patient in critical care becomes classed as a delayed transfer of care (DToC) if they have not been transferred to an appropriate ward bed within four hours of being assessed as no longer requiring critical care.

The Welsh Government wants health boards to reduce critical care DToCs by 10 per cent every three months, until the percentage of bed hours lost per quarter does not exceed five per cent of critical care bed occupancy.

Wales’ six health boards with critical care units have all experienced above average DToCs in recent times.

In Gwent during March to December 2014, the lowest monthly critical care delayed transfer situation, for bed hours lost, was nine per cent, last July and August, though it reached 20 per cent during that period too.

At Nevill Hall during those 10 months, the rate of bed hours lost dipped below 10per cent on just a couple of occasions, but in November hit 30 per cent.

A key reason for delayed transfers in critical care is that at busy periods, priority for ward beds has gone to ‘front end’ moves, of patients who have come in through emergency departments, so pressure on A&E and medical assessments units can be eased.

Often too, patients in critical care units may need a speciality bed on a specific ward, that may not be available, rather than the first available general bed.

A third issue is that critical care patients suitable for transfer may stay on units longer than necessary if they are not moved by 5pm as it is recognised that transfer after this time carries a greater clinical risk.

Aneurin Bevan University Health Board is introducing a plan that endeavours to make one intensive care bed available immediately the last bed is used, so critical care units will have an admitting capacity of one level three bed at all times.

There will also be priority over the movement of A&E waits of more than 12 hours, and urgent elective cases, and all transfers will be carried out by 5pm.