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18.11.14

Lack of social care forcing 1,000 patients a day to remain in hospital needlessly

A lack of social care has resulted in more than 1,000 patients a day being forced to remain in hospital as there is no one to care for them when they are sent home, a new report has found. The resulting bed backlog is threatening to “bring the NHS to its knees” experts warn.

Every day, doctors and nurses in England are unable to discharge more than 1,000 patients who no longer need treatment because there is no care available for them at home or in the community, according to a new investigation by Sky News.

According to their analysis of statistics on one day in September, 4,966 patients were unable to be transferred either to other parts of the NHS or into the care of local authorities – the highest level since September 2010.

Sir Bruce Keogh, the medical director of NHS England, said that it was a “major issue”.

“I’m really concerned about it,” he told Sky. “If you can’t get patients out of hospital back into their own homes, then the whole system backs up, you can’t treat people effectively in A&E, then ambulances start to form queues at the front door of the hospital.”

The problem is sometimes referred to as “bed blocking”, but many dislike that term, which treat people as the problem, not the system.

For example, Richard Humphries, assistant director for policy at the King’s Fund, tweeted: “Suspending tweet-free holiday to object to media reports of 'bed blockers'- horrible term, system blocks people not other way round”.

He also recently tweeted that there has been a 33% rise in “delayed days”, days of care lost due to delayed transfers, with waits for nursing home beds now accounting for 14% of total delays. Sky News put the total number of days lost in September at 138,068.

At £250 a day for a hospital bed, that figure suggests the NHS is wasting more than £34m a month looking after patients who no longer need to be there.

A recent survey by Cambridge University NHS Trust found that 18% of acute adult inpatient beds were occupied by people who had finished their clinical care and could move on.

More than 25% of the delays are being attributed to a lack of social care, funding for which has dropped significantly since the Coalition came to power. Under pressure from the government, local authorities have cut social care budgets by about a fifth, almost £3.5bn in total.

Chris Hopson, chief executive of the Foundation Trust Network (FTN), which represents hospitals, said: “We are going back downhill to 15 years ago, when the NHS was an international joke because you had to wait years for treatment and wait potentially most of a day in an A&E department.

“Nobody wants to go back to that, but you get what you pay for.”

Dr Susan Robinson, an A&E consultant at Addenbrooke's Hospital, said: "If we're crowded, it's because the hospital's crowded, and the hospital's crowded because they can't get certain patients out. The crowded hospital is almost bringing us to our knees."

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