The health and social care system’s management of discharging older patients from hospital does not represent value for money, according to the National Audit Office in a report launched yesterday
The spending watchdog estimates that the gross annual cost to the NHS of treating older patients in hospital who no longer need to receive acute clinical care is in the region of £820 million, putting additional and avoidable pressure on the financial sustainability of the NHS and local government. Longer stays in hospital can have a negative impact on older patients’ health as they quickly lose mobility and the ability to do everyday tasks.
The report echoes the findings of the Alzheimer’s Society Fix Dementia Care: Hospitals campaign which highlighted poor care for people with dementia in hospitals and poor practice in the discharging of patients.
George McNamara, Head of Policy at Alzheimer’s Society said: ““The fact that so-called ‘bed-blocking’ in hospitals has risen by a third in two years is unacceptable – and comes at a huge human and financial cost.
“Our Fix Dementia Care campaign found that substandard care and poor discharge processes can have devastating, life-changing consequences for people with dementia, who occupy a quarter of hospital beds. Too many are falling while in hospital, being discharged at night or being marooned in hospital despite the completion of their medical treatment, affecting whether they stand any chance of returning to their own home or not.
“Not only is this a waste of taxpayers’ money, but also further evidence of a health and social care system that is not joined-up or adequately funded to ensure the best possible care for people with dementia. It is vital that we get this right for people affected by the condition.”
Nick Sanderson, CEO, Audley Retirement, commented: “There is still far too much of a blinkered view on the end problem, rather than preventative measures. Appropriate support in the community will naturally allow patients to be discharged in the knowledge that they will receive the necessary level of care. However, surely delaying these visits in the first place is the first step to easing the pressure? A lot of this comes from high quality housing offering flexible care that can be implemented as and when required, and research has shown this to be the case.
“The International Longevity Centre (ILC) has found that living in accommodation which both facilities independent living, yet offers this flexible care is associated with a lower uptake of inpatient hospital beds. That’s something that can’t be ignored. Not only this, but it even allows early discharge as patients are returning to a purpose-built home, with the right support to enable early rehabilitation if needed. It won’t be solved immediately, but if we adjust the spotlight and focus on promoting high quality of life and wellbeing in the first place, it will go a long way to minimising these costly delays.”
Care England, a representative body for independent social care providers, welcomed the National Audit Office’s report on Discharging Older People from Acute Hospitals, and has called on the Government to join up health and social care, by using and building capacity in care homes.
Professor Martin Green OBE, Chief Executive of Care England said: “The National Audit Office’s report highlights, yet again, the blockages in the system. It estimates that 85 per cent of patients subjected to delayed discharges are aged 65 and over. As we have always maintained, shaving money off social care is false economy for the NHS. Older people are getting a raw deal owing to short-termism, and a lack of understanding of the costs of care and the route to timely discharge. This is depriving older people of their health, independence and dignity.”
The report reminds us that there are far too many older people in hospitals who do not need to be there. Without radical action to increase social care funding now and in the future, this problem will worsen and add further financial strain to the NHS and local government.
Martin Green continued: “Often, older people are ready to be discharged from hospital, but they lack the necessary ongoing support. The discharge process needs to be better managed and planned; not forgetting the role that care homes can play in offering step-down and intermediary care, if they can be sustained by realistic funding levels.”