Hospital bed-blocking 'rising'

Elderly patient Bed-blocking had been falling for much of the past decade until recently

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Patients are facing increasing delays in being discharged from hospital, figures obtained by the BBC suggest.

The problem - known as bed-blocking - happens when support from social care or district nursing is not available in the community for vulnerable patients.

Department of Health data shows that in the last two months, there were more than 128,000 days of delays in England, up 11% on the same period last year.

The rise comes after rates have been falling for much of the past decade.

Major problem

Bed-blocking was viewed as a major problem at the turn of the century.

But numbers started to fall after social care and the NHS were encouraged to develop joint teams to ensure the most needy patients - mainly the elderly - had the right support when they were ready to leave.

To ensure the system worked properly, services can face fines if they fail to put in place the right support.

However, the data released by the Department of Health after a request from the BBC has suggested that trend has now reversed.

Growing pressures

  • Bed-blocking is not the only area of concern in the NHS and social care
  • Pressure is also building on waiting times - overall, the NHS is still meeting its target of seeing 90% of patients within 18 weeks, but that masks the fact that in a third of areas it is being missed
  • Some trusts are also restricting access to some services, such as IVF and minor surgery, in a bid to save money as the health service has to find £20bn of savings in the next four years
  • In social care, budgets are being stretched by the government's decision to cut funding to councils by a quarter in the next four years
  • Many councils have stopped providing support to all but the most needy residents

Between 2003 and 2009 the number of days patients spent delayed was falling. It then started rising, but there were concerns about the quality of the data.

So in August 2010 the Department of Health introduced a new system and started carrying out more rigorous checks.

The figures still show numbers are going up. Since the new system was introduced, the number of days of delays has risen by 11% from 115,648 during August to September 2010 to 128,517 in the same period in 2011.

Peter Hay, president of the Association of Directors of Adult Social Services, said: "This should act as a warning. We have seen huge falls over the last decade and with the financial situation this could be the turning point."

Jo Webber, of the NHS Confederation, agreed, linking it to the rise in waiting times that have been seen in recent months.

"This is a worrying sign of the pressure which is building in the system. Like waiting times, it is a pinch point."

While the number of days lost still represents a small proportion - just over 2% - of the overall number of days all types of patients spend in hospital, it can still have a significant impact on badly-affected departments.

The cost of providing a bed in hospital is £255 a day on average, and a delayed discharge also means the speed at which hospitals can admit patients is slowed.

But Dr Ian Donald, of the British Geriatrics Society, said: "The trouble is hospitals operate on such tight margins. Even small delays can cause problems."

And he said the impact on the individual could be even worse.

"Delayed discharges are not just statistics, but individual patients who are frail and vulnerable. To them and their families it can feel like they are stuck and lost in the system."

A Department of Health spokesman said improvements in the way the data was being collected could be a factor in the rise.

But he added the government was "committed to tackling" delayed discharges, and as a result money was being set aside to be specifically invested in community teams to help people when they left hospital.

"No-one should be made to stay in hospital longer than necessary. The NHS and social care must work together to ensure people have the support they need on leaving hospital."

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