Lord Dubs: Tory neglect of our health and social care system has had direct impact on most vulnerable
One of the key challenges for the NHS is achieving a safe and speedy discharge for older people who are no longer in need of acute care but who are unable to return home immediately, says Lord Dubs.
The continuing neglect of our health and social care system by the Conservative government has had a direct impact on our most vulnerable citizens with an ever growing number of people in hospitals waiting to be discharged to care homes.
In 2016/17 delayed transfers totalled to the equivalent of 2.3 million days in England alone. This was even worse than the year before, with delayed days being up by 25% and the cost to NHS providers of £173m.
One of the key challenges for the NHS is achieving a safe and speedy discharge for older people who are no longer in need of acute care but who are unable to return home immediately. The 2016 efficiency report by Lord Carter noted that 1 in 10 hospital beds were taken up by people who were fit for discharge resulting in unnecessary costs, delayed operations and increased waiting times in accident and emergency.
One of the biggest reasons for this was people having to wait to be transferred from a hospital bed to one in a residential home or suitable home care package. Although the majority of delays are still attributable to the NHS, delays attributable to local authority social care have risen by 85% over the past two years.
This will only get worse in the winter months where more hospital beds are needed. The average amount of bed occupancy in the winter months is 95%, well above what is deemed to be safe. Many parts of the country are facing further reductions in order to deal with current financial pressures.
The Kings Fund have warned that the UK already has less acute beds than any comparable country. Whilst, there are opportunities to make better use of existing bed stock by preventing avoidable admissions and improving the discharge of patients, they advise that further significant reductions are both unachievable and undesirable.
The CQC has warned that while the need for social care continues to rise, there were almost 4,000 fewer beds in nursing homes in March 2017 than there were in March 2015. There is wide variation in the regional distribution of these numbers as adult social care providers respond to local pressures. In a small number of areas, the number of nursing home beds has fallen by more than 20%; in others, the number of beds has increased.
The Government has set much store by the Better Care Fund (BFC) but. it simply isn’t providing a satisfactory amount of additional resources. Although BCF has increased it’s spending in this area, the Association of Directors of Adult Social Services (ADASS) pointed out that pressures from the NHS are increasing and the Better Care Fund (BCF) is not providing the additional resource that social care requires. Indeed, ADASS argues that it provides no more resources in real terms than the NHS transfer to social care in 2014/15.
In an oral question in the Lords today, I will asks the government to be clear about how many people they estimate are currently in hospital waiting to be discharged to care homes when places become available.
Back in July, in a written statement to Parliament, Health Secretary Jeremy Hunt said that delayed transfers of care should not make up any more than 3.5% of all hospitals beds by September. Has this target been met? If it has failed to be reached, then not only will the people waiting to be transferred will suffer, so will people who desperately need hospital treatment but cannot get it due to a lack of beds.
Lord Dubs is a Labour peer in the House of Lords