Hospital patient faced nine-month social care wait before discharge, FOI request finds

Hospital patients who are medically fit to be sent home have been forced to wait at hospital for months on end while provisions are made to get them safely home or to a care home, new figures have suggested.

Data obtained by the HSJ found one patient waited for nine months while arrangements were made with local social care teams.

Labour said it was “absolutely horrifying” that patients fit to be sent home were stuck in hospital beds for so long.

Many hospitals have struggled with what is known as “delayed discharges”.

This occurs when patients, often elderly, are medically fit to be sent home from hospital but before they are sent home, arrangements need to be made by social care teams to make sure they are safe.

This could include a number of support measures such as grab rails, ramps, carer support or potentially arrangements for someone to move into a care home.

Cuts to budgets have meant that social care teams are struggling to get though heaving case files.

Meanwhile, leaving medically-fit patients on wards can lead to problems with “flow” around a hospital – for instance, if a patient comes in as an emergency they may have to wait longer for a bed on a ward.

The HSJ decided to perform a detailed analysis at seven NHS trusts which have historically had trouble with delayed discharges.

Its Freedom of Information requests found that:

• At North Bristol Trust, one patient waited more than nine months to be discharged while another waited around eight months.
• North Cumbria Integrated Care Foundation Trust and Gloucestershire Hospitals NHS Foundation Trust each had patients who waited at least six months.
• Royal United Bath reported a case of more than five months while Dorset County Hospital, Mid Cheshire Hospitals and Stockport NHS Foundation Trust each reported cases involving delays of three months or more.

The trusts said most of the long delays were caused by a lack of domiciliary care while other factors included waits for equipment in people’s own homes, HSJ reported.

Labour’s shadow health secretary Wes Streeting said: “It is absolutely horrifying that patients who are fit to leave hospital are then stuck in hospital beds for up to nine months. It’s a shocking waste of the best part of a year of someone’s life.

“This is the cost of the Conservatives’ failure on social care over the past 12 years.

“Labour will recruit more care workers by ensuring full rights at work, decent standards, fair pay and proper training as the first step towards a National Care Service.

“We will ensure care is there for all who need it and free up NHS beds for patients waiting for treatment.”

A Royal United Hospitals Bath NHS Foundation Trust spokesperson said: “The RUH, like other hospitals across the country, is experiencing challenges discharging patients who require further support in the community from social or community care providers.

“To overcome this, we are working closely with partners across Bath and North East Somerset and Wiltshire to take forwards a Home First programme helping patients return home as soon as they are well enough.

“As part of this we have launched a home care agency, United Care Bath and North East Somerset, with the council to help patients get home with the right level of domiciliary care they need.”

A spokesperson for NHS Bristol, North Somerset and South Gloucestershire Integrated Care Board said: “Stays of several hundred days are rare and usually involve very complex cases with individuals who require significant ongoing care needs outside a hospital environment.

“We recognise the frustration and distress that delays cause and are focused on bringing long stays down.

“We are investing £17 million to improve hospital discharge over the coming months, bringing the whole system – including council partners and our community provider – together to better co-ordinate people’s discharge, improve people’s hospital journey, reduce length of stay and ensure that everyone can move on from hospital once they are medically well enough to do so.”

Last month’s performance figures for the NHS in England showed only 40% of patients were able to leave hospital when they were ready to in July.

On average, there were almost 12,900 patients a day who spent more time in hospital than needed in July.

NHS England launched a 100-day “discharge challenge” trying to encourage leaders to improve discharges where possible.

There is also a Discharge Taskforce which looks across the health service and local government to try and improve discharge rates.

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