Hospital Dr News

‘Bed blocking’ by older patients likely to continue for up to five years, NHS chief admits

The NHS England Chief Executive has admitted that delays in discharging older patients from hospital are likely to continue for up to five years.

Simon Stevens told MPs that ‘bed blocking’ would continue because of the pressures on social care.

A recent National Audit Office report estimated that delayed discharge is costing the NHS £820m per year.

It concluded the main reasons for delay are problems with organising a home care package or residential care placement.

A senior Department of Health official, John Rouse, also told the public accounts committee there was an unacceptable variation in performance, but that more than 40% of local authorities providing social care had reduced delays.

The department has previously said the issue would be tackled as councils get £3.5bn more for adult care by 2020.

The Royal College of Emergency Medicine said Stevens’ five-year estimate was “conservative”.

It said the situation is rapidly deteriorating, and in A&Es it is usually due to a lack of in-patient beds which results in patients being ‘held’ in the department.

This means that departments fill up with patients who should be in a ward and new arrivals whether self-presenting or arriving by ambulance find there is no clinical space available in which they can be seen or treated.

The knock on effects are longer waiting times in A&E, enormous pressure on staff and a higher risk of death for patients – over 500,000 patients a year are affected by it, which in turn accounts for more than 500 deaths every year.

Dr Clifford Mann, President of the Royal College of Emergency Medicine, said: “Working in overcrowded departments, where care is constantly impaired as a consequence, saps morale and is a key cause of burn-out and poor retention of staff.

“If this is not tackled, the increased pressure on staff will become too much to bear and will make recruiting to posts even harder than it is at present. This in turn will put patients at even greater risk.”

The College believes that cuts to social care have also exacerbated the problem, with more patients occupying beds for longer, simply because they now have nowhere to go for after-care.

In a time of austerity there are no easy solutions, but to help tackle exit block, the College has issued guidance and proposed to Monitor an innovative tariff system that would incentivise its elimination.

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