Welsh Audit Office criticises under-reporting of bed blocking

Delayed transfers of care in Wales are under-reported because of poor measuring by health and social care bodies, a new report says.

A Wales Audit Office investigation found agreements between NHS trusts and councils do not record patients as being delayed for between 7-15 days after an assessment to allow a community care package to be put in place.

It called on Welsh assembly government, local authorities and health trusts to develop better systems for dealing with delayed transfers of care and take more of a partnership approach to managing the system.  

It says the poor measuring – evident in all but one of the areas it looked at – “masks” the extent of the problem in Wales and underestimates the impact delayed discharge has on the independence of vulnerable patients. It calls for the scrapping of local agreements and for the Welsh assembly government to monitor this.

“As most patients whose transfer of care is delayed face an average delay of 55 to 82 days in Gwent, Cardiff and Vale NHS Trusts, building in further delays not only underestimates the extent of the problem but also impacts on the quality of patient care,” it says.

The report also reveals that some patients with learning disabilities whose transfer of care is delayed in assessment and treatment units haven’t been counted in official figures. It calls on the Welsh assembly government to ensure a more consistent approach.

While the number of people experiencing delays has dropped over the past two years, the report shows the total number of bed days lost to delayed discharges has grown by 2% to 268,491 at a cost £69 million in 2006-7. Delayed transfers of care in the four areas measured – Cardiff, Vale of Glamorgan, Carmarthenshire and Gwent – accounted for half of bed days occupied by delayed transfers.

The reasons for delays varied from area to area. Nationally half were due to patient choice with the remainder evenly split between health and social care reasons. In Cardiff, patient delays for social care reasons have dropped by 5% where as in Gwent there was a 64% rise from 2005-7.