- Patients left lying in hospital because of lack of adult care services
- Total number of delayed discharges up 30 percent since 2011/12
- Government attempts to alleviate the adult care crisis having no effect
By Chaminda Jayanetti
The number of delayed discharges in the NHS and adult care system reached record highs in 2015/16 amid the ongoing social care crisis, according to official figures published yesterday.
The number of patients whose discharge from hospitals and other health facilities was delayed for non-clinical reasons rose by nearly 10 percent in 2015/16, to more than 60,000 – a rise of nearly 30 percent since 2011/12, the first full year in which the data was measured.
The total length of delayed discharges reached more than 1.8 million days, up nearly a third since 2011/12. This suggests that each delay lasts a month on average.
Delayed discharges are officially called Delayed Transfers of Care, and are sometimes dubbed “bed blocking” as they mean hospital beds cannot be cleared for new patients, although this term is now seen as pejorative.
They are regarded as a result of the crisis in adult care, where a combination of fragmented, marketised services, government funding cuts and a growing elderly population means there are not enough care services for people to access when their hospital treatment is complete.
As a result, they have to be kept in hospital even after their treatment is over, putting pressure on NHS resources.
Most of the delayed discharges are from NHS acute hospitals, which have risen by almost 50 percent since 2011/12. However, the largest one-year rise was in delayed discharges from non-acute settings, including mental health and community health facilities.
The three biggest causes of delayed discharges are people awaiting completion of an assessment, people waiting for further non-acute NHS care, and people waiting for an adult care package to be prepared for their own home to allow them to live independently. These three factors together caused more than half of the 63,167 delayed discharges in 2015/16.
Councils are increasingly trying to get frail and disabled people to live in their own homes for longer to reduce demand for costly residential care homes – but it seems these same cash-strapped councils are struggling to keep up with demand, with the number of delayed discharges caused by people awaiting a care package in their own home more than doubling since 2011/12, from 5,088 to 10,884.
Another cause of delayed discharges – people waiting for a place to become available in a nursing home – has risen by more than 50 percent since 2011/12.
When Chancellor George Osborne made councils the target of austerity in 2010, critics warned it would create a social care crisis that would rebound on the NHS. Because councils fund adult care services, stripping them of money would reduce the number of people they could cater for, meaning that people would be left languishing in the NHS instead, pressurising those frontline health services. These warnings went unheeded.
Since then the government has begun to respond. Councils and local NHS commissioners are now given extra funding if they meet targets to reduce delayed discharges, but the new figures show this is not having an effect.
The government also allowed local authorities to raise council tax specifically to fund adult care services from April this year. However, as Sentinel News revealed last month, this still leaves a £1bn black hole in adult care services caused by rising demand and government funding cuts in 2016/17 alone.