Councils reducing delayed discharges at faster rate than NHS

Councils are reducing delayed discharges from hospital “consistently and at a faster rate” than the NHS, the Local Government Association has said.

The latest figures show that delays attributable to social care have fallen by approximately 33% since July 2017, compared with 8% for delays due to the NHS.

Between March and April 2018, delayed discharges due to social care fell by 4.4%, while delays due to the NHS fell by 1.7%.

A spokesperson for the LGA told Community Care that this has largely been achieved due to the work of the Care and Health Improvement programme, delivered by the LGA and the Association of Directors of Adults’ Social Services (ADASS).

The programme team is providing intensive support to help areas address delayed transfers of care and “system-flow” issues, the spokesperson added.

Councils have also invested extra monies from the Improved Better Care Fund, one of several funding streams for social care, in services designed to avoid hospital admissions and improve discharges, which has sped up progress.

‘Missed targets’

In July 2017, health and social care secretary Jeremy Hunt threatened to review 2018-19 funding allocations for councils that failed to meet targets on cutting delayed discharges.

The targets meant that councils with the worst rates of delayed discharges attributed to social care had to cut it by two-thirds by September that year.

At the time, Hunt said the changes would speed up progress on cutting delays and help free up the hospital beds needed to improve NHS performance over winter.

The LGA spokesperson told Community Care the targets were “unrealistic” and “way above” those originally agreed by Health and Wellbeing Boards, and as a result not all areas had managed to meet them.

However, as far as the Association is aware, no councils have had their 2018-19 funding allocations reviewed in the light of the missed targets.

‘Ongoing fines’

NHS trusts are also continuing to levy fines on local authorities where delayed discharges are due to problems sorting out social care packages.

Under the Care Act 2014, a NHS body can charge a council for a delayed discharge if it has received an assessment and discharge notice, but has not carried out the needs or carers assessment and the patient has not been discharged “by the end of the relevant day”. Fines can also be imposed if a discharge is delayed due to care arrangements not being put in place.

The latest ADASS budget survey found 13 councils were fined, with a further five NHS trusts expressing the intention to do so. The average fine per authority was £95,000.

An earlier survey of directors found fines of up to £280,000 were being issued.

The LGA said this practice was “strongly discouraged” and the focus should instead be on partnership working and jointly investing money in services that support people to stay well at home or to be discharged safely and effectively.