The government has branded the NHS hospital discharge system “broken” as a survey revealed almost a fifth of care providers across the UK reported weeks-long waiting times for people to be transferred into their care.
The survey of 568 care homes and homecare providers across England, Wales, Scotland, and Northern Ireland found wide regional variations and prompted sector leaders to say “enough is enough” as they repeated calls for urgent reform of the social care system.
Some 17 percent of respondents said the average length of time for a person to be discharged into their care from hospital is one to two weeks, while around 7 percent said the average wait was three or more weeks.
A lack of agreement on how the person’s social care would be paid for was the most common reason for delayed admission to a care provider, the survey found, with more than 200 respondents citing this reason.
Others said wrong or insufficient information provided to them from hospital discharge teams, a lack of communication, waits for patients to have care assessments, or transport not being agreed all contributed to delays in people being moved from hospital to a care provider.
The east of England performed best when it came to people being discharged, according to the survey, with around 96 percent of patients admitted to a care provider within a week.
Meanwhile, half of providers surveyed in Scotland said discharge times took more than a week, while 15 percent of those surveyed in the West Midlands and 10 percent of those in Yorkshire and the Humber said it took over three weeks to get a patient admitted into their care.
Autumna, which carried out the survey and describes itself as the UK’s largest and most comprehensive later-life care directory, said the samples from Wales and Northern Ireland were too small to provide reliable regional findings.
The latest NHS figures, for July, show that across England an average of 22,310 hospital patients a day were ready to be discharged to a number of settings rather than just to care homes.
Of these, a total of 9,984 (45 percent) were discharged and 12,326 (55 percent) were not, according to NHS England.
The proportion of medically fit patients who were discharged varied across the regions, with 60 percent discharged from hospitals each day on average in eastern England, but only 36 percent in the northwest of England.
The latest figures for Scotland, published earlier this month, showed the number of beds occupied by those stuck in hospital who are well enough to be released – overall rather than just those needing to go into care homes – had hit the highest level on record.
Statistics from Public Health Scotland showed the average number of beds occupied per day by those who should have left hospital was 1,983 in June, up from 1,942 in May and the highest on record since the category was created in July 2016.
The Labour Party ran on a manifesto that pledged to “develop local partnership working between the NHS and social care on hospital discharge” as it builds a National Care Service.
Autumna’s survey found that 93 percent of care providers would like to see government reform of the hospital discharge process, with the organisation saying the problem is not about capacity in the system but rather centres on “identifying approved available care provision and communicating appropriate information to enable a clear and accountable hospital discharge.”
‘A System That Is Failing’
Professor Martin Green, chief executive of Care England which represents many providers across the country, said the report “clearly outlines a system that is failing and will only get worse unless remedial action is taken.”He added: “Care providers are frustrated and angry by the lack of a clear and strategic approach to discharge, and the fact that nobody is delivering a national perspective.
“We are constantly hearing about bottlenecks within hospitals, the root cause of which is often a lack of a clear and strategic approach to appropriately discharge patients.
“This pressure on the NHS is often self-made and is a symptom of a system that is obsessed with organisations and processes and has forgotten that people and outcomes should be the priority.”
He said more effective work with the social care sector, including giving it the required resources, would mean “the solutions would be easily and readily available.”
Mike Padgham, chairman of the Independent Care Group, representing adult social care providers in York and North Yorkshire, said: “This is the latest in a long line of reports that paint a bleak and unacceptable picture for people who need care.
“Enough is enough, the system is in need of reform so that people can get the care they need, when and where they need it.”
He described the current process as an “unnecessarily complex system which delays people from getting where they want to be,” adding, “We need a system that allows hospitals to discharge people directly to care providers to get people moving more quickly.”
Autumna founder Debbie Harris said the survey was the first to “probe the experiences of social care providers of the hospital discharge system” and finds a system that is “failing due to poor relationships caused by poor communication.”
She added: “Our findings are a wake-up call to [Prime Minister Sir] Keir Starmer and [Health Secretary] Wes Streeting that the system is broken and urgently needs reforming.
“The pressures are only going to get worse as our population gets older, so we need to fix the system now, before it completely breaks down.”
A government spokesperson said: “Our broken NHS hospital discharge system is blocked by an inadequate and neglected social care system.
“This government is committed to reforming the adult social care sector and building a National Care Service to deliver high-quality care across the country and ease pressure on the NHS so it is fit for the future.”
An NHS spokesperson said: “All health and social care partners recognise that the current level of delayed discharge is unacceptable.
“We are working closely with colleagues in social care and local government to make improvements, following the successful rollout of care transfer hubs, which help to coordinate care and support for people who need it, alongside our new discharge ready date measure, which records the length of delay once a patient is ready to leave with the aim of reducing it.
“We know there is more to do to improve processes and maintain the appropriate capacity in all parts of the system, and this will be a key priority for us as we go into winter.”
