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Thousands of extra beds in care homes and other settings are set to be brought by the government as part of a £250 million short-term plan to reduce the current pressure on the NHS.
This means that more than 13,000 medically fit patients will now be discharged into the community to free up hospital beds for those who need them. It is hoped they will receive support from GPs, nurses and other community-based clinicians to continue their recovery before returning to their homes.
The additional £250 million will fund maximum stays of up to four weeks per patient until the end of March. After that, patients will be booked into beds most appropriate to their needs.
Of this funding, £50 million will be allocated to upgrade and expand hospitals including new ambulance hubs and facilities for patients about to be discharged.
Health and Social Care Secretary Steve Barclay said: “The NHS is under enormous pressure from Covid and flu, and on top of tackling the backlog caused by the pandemic, Strep A and upcoming strikes, this winter poses an extreme challenge.
“I am taking urgent action to reduce pressure on the health service, including investing an additional £200 million to enable the NHS to immediately buy up beds in the community to safely discharge thousands of patients from hospital and free up hospital capacity, on top of the £500 million we’ve already invested to tackle this issue.”
Government playing catch up in the middle of a crisis
Health leaders said that after a decade of austerity and a previous Prime Minister boasting of building forty new hospitals and claiming social care was ‘sorted’, it was good to see Number 10 taking responsibility.
Yet they said that reality is that holding a Downing Street summit about a crisis in the midst of that same crisis shows the government is playing catch up.
Matthew Taylor, chief executive of the NHS Confederation, said: “NHS leaders will welcome the Prime Minister’s acknowledgement of the scale of the challenge facing the NHS this winter.
“NHS leaders, collaborating with local authority and voluntary sector partners, have been working innovatively to manage demand, create extra capacity and use it as intensively as possible, but there are no silver bullets and there is now only limited improvement that can be achieved this winter. The reality is that there is a widening gap between the NHS’ capacity and the demand it is facing, and this has left the NHS in a fragile state.
“We await the full details of the proposed hospital discharge fund with interest. Given the on-going delay in distributing the delayed discharge fund announced last autumn any funds will need to be rapidly deployed. It looks as though a key focus will go towards discharging more patients from hospital into care homes. This is a better alternative than medically fit patients being prevented from leaving hospital but, as social care colleagues have often warned, it also runs the risk of people being inappropriately placed and then remaining in residential provision indefinitely. Strengthening community capacity in both health and social care is the answer but this takes investment and time.”
He added that while it is important that people who are medically fit should be able discharged from hospital as soon as possible to support their recovery as well as relieve pressure on the demand for beds, this push could end up having unintended consequences elsewhere by putting additional pressure on primary care services which are already very stretched.
New ideas to reduce discharge delays in hospitals
In addition to the new funding for care home beds, the government is trialling six National Discharge Frontrunners which could reduce discharge delays, moving patients from hospital to home more quickly.
Sussex Health and Care, the Northern Care Alliance, Humber and North Yorkshire, One Croydon Alliance, Leeds Health and Care Partnership and Warwickshire Place have all put forward ideas that will help the patients in their area move out of hospital more quickly whilst providing continuity of care. These ideas include dedicated dementia hubs, new offers of provision for rehabilitative care and creating effective data tools to help manage demand for discharge of medically fit patients – giving them the help they need to live comfortably in the community after a hospital stay.
This new programme will trial long term solutions to issues which result in patients staying in hospital longer than necessary. For example one area, Leeds, is looking to improve how health teams in their local hospitals are working with those providing community services such as rehabilitation, which will mean better support locally for patients who need support after a hospital stay.
Sarah-Jane Marsh, National Director of Urgent and Emergency Care said: “There is no doubt the NHS is under pressure with latest weekly data showing flu cases in hospital increased by almost half putting additional strain on already busy wards and departments.
“We want to ensure all patients ready to leave hospital do so quickly and safely, and NHS staff are working closely with local authority colleagues to help get more patients out of hospital when they are medically fit to do so.
“We hope the frontrunner programme will offer new solutions for local systems to help patients access the services they need and help to free up bed space in NHS hospitals.”