NHS powerless in face of a discharge crisis
The NHS is facing a crisis. Hospital trusts seem powerless to halt spiralling numbers of healthy patients being stuck in hospital beds because they can’t be discharged.
Virtually every month for the last year has seen record breaking numbers of ‘delayed transfers of care’ – where otherwise healthy patients are stuck in a hospital bed because the care and support they need to leave is not in place.
The latest figures show more than 171,000 hospital bed days were lost because of delayed transfers of care in June alone, taking the total for the year to nearly two million. And it’s mainly older people that are suffering from this crisis, with 85% of those affected aged 65+, according to the National Audit Office (NAO).
These figures are unprecedented and unsustainable. Last year the NAO estimated that delayed transfers of care cost the NHS £820million, a cost it cannot afford.
Not only does this crisis pile pressure on top of the already creaking NHS, it has a significant negative impact on the health and well-being of individual older people, for example increasing the risk of muscle damage when stuck in a bed. We cannot simply accept this as a routine feature of hospital stays.
It is no coincidence that this crisis has followed the cutting to the bone of social care budgets across the country. A significant proportion of delayed discharges are related to social care – last month 42,000 bed days were lost to patient waiting for a place in a residential or nursing home. And 32,000 were lost due to patient waiting for a care package in their own homes.
It is not surprising that the NHS seems powerless to stop this discharge crisis from growing, when it’s being left to deal with the consequences of a chronic underinvestment in social care. Between 2009/10 and 2015/16 social care services in England faced a funding reduction of £4.6bn. If councils cannot afford to provide older people with adequate social care support, they will be more likely to end up needing to go to hospital or be unable to leave.
The NHS and social care systems must be able to work together to deliver the support that older people need in order to live independently. A timely discharge from hospital doesn’t simply free up a hospital bed, it allows the individual to return to their social activities and networks, to their daily home life with all the physical and mental health benefits that this brings.
We will not find a solution to this crisis unless we take a comprehensive, wide-ranging look at the future funding of our health and social care systems. Hospital will be central to that solution, but so will local councils, the government, social care providers and older people themselves. Only by bringing all these parties together to hammer out a solution to the crises facing the health and care system, as we advocate in our Care for Tomorrow campaign, will the problem of delayed hospital discharge be resolved.
