Delays in discharging people from hospital due to problems arranging social care support rose sharply this summer, NHS figures show.
Between April and September patients spent 261,324 extra days in hospital due to social care issues – an increase of 33% on the same period last year.
Around 30% of all delayed discharge days are now due to social care. Last year the figure was around 25%. Hold-ups sorting out home care packages are the most common reason, accounting for more than a third of cases.
Delays where both social care and health services were responsible rose 23% – from 52,406 days last summer to 64,617 this year. Delays attributed solely to the NHS rose 0.29% – from 526,998 to 528,552.
James Thompson, an analyst at the King’s Fund, told Community Care that after years where increases in NHS-related delays generally outstripped rises in social care delays, the trend was shifting.
He said: “Although the overall number of delayed discharges is rising, social care is increasing at a faster rate. The figures suggest issues with the capacity of home care and residential care services. When it’s time to discharge someone it appears there are fewer options.”
More complex needs
Grainne Siggins, urgent care lead at the Association of Directors of Adult Social Services (Adass), said pressures that traditionally spiked during winter were increasingly being felt all year round.
She said: “There are signs more people are being admitted to hospital with multiple needs and long-term conditions and the support they need on discharge is more complex. They often need calls four times a day and double handed care.”
Securing those care packages can be particularly hard when social services are only informed about decisions to discharge a patient at short notice, said Siggins. Some councils are also struggling to recruit enough home care workers to meet demand, despite offering “significant” hourly rates to providers, she added.
Siggins said Adass is working with NHS providers on ways to minimise delays. Revised guidance has been issued and work is underway to promote earlier discharge planning and increased use of reablement and intermediate care: “We need joint planning and to work on this proactively together. These are all system delays and often make things very difficult for individuals who could leave hospital.”
Colin Angel, policy and campaigns director at the UK Homecare Association, said the shortage of care workers to meet the pressures, particularly over winter, was due to “consistently poor” commissioning by local authorities and NHS commissioners.
He said: “To plan successfully, councils and clinical commissioning groups need to include home care providers from across the local market in their forward planning and contract terms need to be agreed between commissioners and providers that will enable effective recruitment.
“Just expecting providers to deliver over winter on existing purchasing arrangements is simply not going to work.”
Councillor Izzi Seccombe, the Local Government Association’s community wellbeing spokesman, said: “Health and social care leaders widely recognise that a properly funded social care system is essential to alleviate the pressures on the NHS.
“We urgently need adequate funding for social care from the government in the spending review to make sure that local areas can deal with winter pressures – or we risk leaving our most vulnerable to suffer unnecessarily in hospital in the coming months.”
A Department of Health spokesperson said the government was increasing funding for the NHS, adding: “This will tackle the underlying challenges to join up care for patients, improve access through seven day services and do more to prevent illness in the first place.”