When one in seven hospital patients no longer needs to be there, the question isn’t whether to act, it’s how to solve this growing problem. At Chelsea and Westminster Hospital and Hillingdon Hospital, a digital discharge platform and a determined team proved that real-time data changes everything. Now the model is ready to travel.
The challenge
On any given day across North West London’s (NWL) hospitals, around 15% of inpatients no longer meet the clinical criteria to remain in hospital – what the NHS terms ‘no-criteria to reside’ (NCTR). These patients are medically fit to leave. But without a clear, real-time picture of where each person is in their discharge journey, delays accumulate. Beds stay occupied. Capacity is lost.
The outcome
At Hillingdon, the results of the OPTICA deployment were clear: NCTR bed days fell by 23% for patients on P1 and P3 discharge pathways. Decisions were made faster. Communication between teams improved. Patients went home sooner.
Beyond the numbers, the evaluation revealed something equally important: the conditions that made it work. A discharge hub team that could see the full picture. A champion with the authority to act on it. And a platform that could carry the learning forward.
When we get traction, it’s because someone inside sees it aligns with something they already want to do and has the courage to take a leadership role in it. The implementation materials produced through this work are now available across the system.
Any acute trust facing similar NCTR pressures can draw on the evaluation findings, the deployment toolkit, and the lessons learned, without needing to commission new work from scratch.
What comes next
The next step of this work was to scale the use of OPTICA across all acute trusts and their respective local authorities in NWL. To support this, North West London ICB commissioned The Public Service Consultants (PSC) as a delivery partner to roll the approach out across the system.
OPTICA’s impact on staff time spent on discharge planning was clear. However, whilst some discharge metrics were positive, some findings were mixed. Despite the 23% reduction (p = 0.031) in NCTR bed days at Hillington, at Chelsea and Westminster, our results were mixed with differences in impact at patient and aggregate-level. This indicates the need for longer-term study.
Partners
- Hillingdon Hospital and Chelsea and Westminster Hospital: OPTICA evaluation sites
- Chelsea and Westminster Hospital: Length of stay prediction pilot site
- NHS England: Partner in developing predictive length of stay tool
- NHS Federated Data Platform: Shared technical infrastructure enabling portability
- ICHP: System coordination, evaluation lead, implementation toolkit, UX research
