‘Frustration’ that hospital discharge funds cannot be spent averting admissions

By Ella Pickover, Reporter28th November 2023News EnglandHospitals, Integrated Care, News England, NHS, Social Care

Health and care leaders have expressed their “frustration” that they cannot spend last-minute winter cash injections for discharging hospital patients on preventing people being admitted in the first place.

In recent years, it has become “normal practice” for the government to provide additional short-term funding pots each winter to help hospitals discharge patients when they no longer need hospital care, a new report states.

The King’s Fund said the funding pots have become “recurring non-recurrent funding”.

A new report from the think tank suggests that the cash often arrives at too short notice, comes with “burdensome” levels of bureaucracy and is required to be spent over too short a period to be effective.

The authors found many health and care workers felt “frustrated” that the money had to be spent on discharging people from hospitals, rather than preventing them from being admitted to hospital in the first place.

“We heard strong views and frustration that funding conditions did not allow for expenditure on prevention,” the authors wrote.

“The conditions of funding should allow expenditure not just on reducing delayed discharges but on preventing avoidable admissions in the first place.”

While local health and care leaders welcomed the money, they told the authors that there was “too little advance notice to develop the most effective plans and ensure value for money”.

Short-term one-off funding pots to tackle delayed discharges should be provided on an exceptional basis, rather than becoming an “annual fixture”, the report concludes.

An average of 12,493 hospital beds per day last month were occupied by people ready to be discharged, according to NHS England figures.

This is up from 12,372 in September, 11,913 in August and 11,877 in July.

A number of issues can prevent patients from being sent home including social care problems such as not having the right support in place, to internal issues in hospitals.

The new report, which was written after the researchers conducted an in-depth analysis of six local health and care systems in England, also found that there was a “lack of shared understanding” between local systems around the causes of hospital discharge delays and the best ways of tackling them.

The authors said the short-term funding pots do not make it easy for local systems to develop the shared data needed to fully understand and tackle the root causes of delays.

Simon Bottery (pictured), a senior fellow at The King’s Fund and co-author of the report, said: “Delayed hospital discharge is a widespread and longstanding problem which affects thousands of patients, their families and loved ones.

“The underlying reasons for delays are often complex and vary between local systems, though workforce issues are often at the root of them.

“Our research shows that it is essential local health and care partners go beyond good surface relationships to develop clear, shared understandings of the causes of delays and the priorities for dealing with them.

“Short-term funding is not the best way to encourage this so government should only use it under exceptional circumstances and instead focus on ensuring that systems have the underlying funding they need to develop and implement long-term strategies.”

A Department of Health and Social Care spokesman said: “We are taking a system-wide approach to reduce the time patients spend in hospital, backed by a record £1.6 billion.

“For this winter and beyond, we are also investing another £1 billion to boost capacity in hospitals as well as creating 5,000 permanent staffed hospital beds.”

An NHS England spokesperson said: “Despite continued pressure on social care and thanks to the hard work and innovation of local NHS teams working with partners, there are hundreds fewer delayed discharges every day compared to the same period last year.

“As well as additional discharge funding, announced and planned for much earlier in the financial year, measures in our urgent and emergency care recovery plan are ensuring continued progress with every trust now having access to a care ‘traffic control’ centre to help direct patients to the best possible place for their needs.”