New figures from Age UK show that since June 2010, an estimated 1,928,255 bed days have been lost to the NHS at a cost of over £526 million to the tax payer, because people’s hospital discharges have been delayed as they wait for social care. There is no age breakdown available for patients affected by delayed hospital discharge but we know that many are older people.
Older people are now having to wait on average one day longer in hospital before finding a place in a residential care home compared to the position in 2010[i]
Patients waiting to be transferred to a residential home in 2013/14 wait an average of 30 days, while someone who needs grab rails or ramps fitted at home waits 27.3 days, 11.5 per cent longer than in 2010. People waiting for a social care package to be put together before they can go home are having to wait an average 28.6 days in total, 5 per cent longer than in 2010.
An NHS bed costs around £1900 a week compared to about £530 for a place in residential care.
These lengthy waits for social care are happening against the backdrop of £1.2 billion (15.4 per cent) having been cut from social care budgets since 2010, mostly as a result of reduced funding for local government, meaning that local authorities are finding it more and more difficult to provide the social care people need.
Because of this underfunding, access to publicly funded social care has also become increasingly restricted, with the vast majority (87 per cent) of local authorities now only able to provide help if a person’s needs have been assessed as being ‘substantial’ or above (with a further two per cent only providing care for those with even more profound ‘critical needs’)[ii] Many older people who struggle with everyday tasks such as getting out of bed and dressing, bathing, preparing meals or doing the shopping are assessed as only having ‘low’ or ‘moderate’ needs and so do not qualify for any help at all. This absence of support leaves many older people at risk of a crisis, which may in turn result in them needing to be be admitted to hospital. Yet good social care can help older people to sustain their health and their independence, relieving the pressure on the NHS.
The consequence of this tight rationing is that from 2005/6 to 2012/13 the number of people aged 65 and over in receipt of social care services actually fell by 27.2 per cent – from 1,231,000 to 896,000[iii] – even though this age group grew by more than one million over the same period.
Although the Better Care Fund which will be transferred from the HNS budget to local authorities and CCGs next year is a considerable amount of money and very welcome. It is not new money and is simply not enough to plug the funding gap or address the financial pressures faced by local authorities and CCGs in 2015/16, which remain very challenging.
Last week the Government launched its consultation on the national eligibility criteria for social care – the threshold of need someone has to pass in order to get help. This is an absolutely crucial decision and it gives the Government the opportunity to start reversing the trend since 2010 of more and more older people being excluded from social care.
Caroline Abrahams, Charity Director of Age UK says:
“The marked rise since 2010 in the length of time people are being forced to linger in hospital because of a delayed assessment, care home place, home care package or home adaptation is an outcome of the crisis in social care.”
“It is crazy to waste expensive NHS resources in this way, when it would be much more cost effective and better for older people to fund social care properly instead.
“Waiting in hospital a month or more for social care to be organised can also undermine an older person’s chances of recovery and be profoundly upsetting for them and their families too.”
“Investing in social care would unblock the log jam and help our hospitals to work more efficiently. A properly resourced care system would transform many older people’s lives for the better and would make financial sense as well. And just think how many more people of all ages could get speedier treatment in hospital if the social care support was there for the patients who can’t be discharged without it.”
“The best thing the Government could do today is to say they will set the national eligibility criteria for social care at a generous level and commit the increased funding this requires. Then we could have a reasonable expectation that these terrible delayed discharge figures can be improved.”
“This report highlights why the LGA has been calling for Government to make a five year commitment to join up funding between health and social care and provide the certainty and stability required to transform care services for the people who need and rely on them.
“We have consistently argued for more money for adult social care. Both councils and the NHS are committed to providing the best possible care, so it is vital that we are working closely together with greater ambition and a sense of common purpose if we are serious about making every effort to create a care system that will improve people’s lives.”