Peers’ amendments aim to reduce likelihood of bed-blocking fines

Social services are less likely to face fines for delayed discharge
as a result of a House of Lords amendment to the Community Care
(Delayed Discharges) Bill.

The peers voted by 134 to 119 to exclude Saturdays, Sundays and
public holidays from being counted in the discharge period. Under
the original proposals it was indicated that fining of social
services would begin three calendar days after notification of a
person’s readiness for discharge.

Liberal Democrat Lord Clement-Jones, who introduced the amendment,
said that weekend discharges were three times more likely to lead
to readmission than discharges which took place earlier in the
week.

As a result of the proposed three day discharge period set out in
the bill, social services could have been told that a person was
ready to be discharged from hospital at 4.30pm on Good Friday, and
be prepared for their discharge no later than 11am on Easter
Monday, or face fines.

If upheld, the measure would mean councils would not have to deal
with older people being discharged from hospital at weekends.

Conservative Earl Howe said changing the bill to three working days
would be “better for patients… because to be discharged at a
weekend or on a bank holiday when community services and home care
may not be available is, to put it mildly, less than optimal”.

It was not reasonable or fair for social services to be fully
staffed for 365 days a year, he added. However, health minister
Lord Hunt, who has subsequently resigned, said he did not see why
older people should suffer “simply because social services do not
work at weekends”.

A second amendment, voted for by 145 to 112, stated that fining
should be delayed until the health secretary had made sure there
was a system of incentives within NHS bodies to discourage them
from discharging patients inappropriately.

Liberal Democrat social services spokesperson Baroness Barker said
the government has made a major concession on the Bill. “Ministers
have agreed to issue guidance to the NHS stating that before a
person is discharged from hospital, an assessment of their need for
NHS continuing care must be done, and records must be kept in
writing.”

The bill now returns to the House of Commons for further debate.