Delayed discharges due to lacking ambition, MPs say

The Commons Public Accounts Committee has accused NHS England of having a ‘poverty of ambition’ over solving the problems related to the delayed discharge of older patients in hospitals.

The report highlighted an ‘unacceptable variation in local performance’ on discharging patients.

The committee called for new measures to tackle the delays which were bad both for patients and the financial sustainability of the NHS and local government.

The report highlighted that good practices such as starting assessments and discharge planning early and having joint shared patient assessments between health and social care providers could greatly improve discharge rates.

However, it warned the absence of widespread and effective sharing of patient information was acting as a ‘significant barrier’ to effective discharge of older patients. Furthermore, the Association of Directors of Adult Social Services told the committee there was local variation in the extent to which community matrons were used. Figures from the National Audit Office showed that the numbers of nurses working in community services had fallen by 13 per cent between 2009 and 2015.

It added that the social care market was being put under increased pressure by problems with recruiting nursing staff to work in private sector home care, and residential and nursing homes.

Meg Hillier, committee chair, said: “Studies indicate older people can lose five per cent of muscle strength per day of treatment in a hospital bed.

“Delayed discharge is damaging the health of patients and that of the public purse. While there have been improvements, the Department of Health and NHS bodies are still failing to properly address the root causes of this problem.

The news comes as the King’s Fund think-tank has confirmed that the incidence of patients medically fit for discharge but stuck in hospital have reached record levels, costing the NHS in excess of £800 million a year.

Richard Murray, director of policy at the King’s Fund, said: “The growing and unacceptable delays in discharging patients from hospital highlighted in [the public account committee] report symbolise the twin crises facing the NHS and social care.

“This increase has mainly been driven by delays in arranging social care for patients who need support when they are discharged, a direct result of year-on-year of cuts in social care funding.”

Dawne Garrett, RCN professional lead for older people and dementia, said: “Older people benefit from being able to go home to their own surroundings and familiar routines as soon as possible after a spell in hospital.

“Nurses working in the community can help people manage their conditions at home, and prevent expensive and disruptive hospital admissions. Failing to invest in these services is costing too much, and causing too much distress, to be allowed to continue.”