Social care cuts stranded 18,500 patients in hospital over Christmas NHS hit by £4.8m bill after lack of provision means more patients cannot be discharged – and more face long waits on trolleys
Almost 18,500 patients spent the holidays in hospital even though they were well enough to be discharged, because a lack of social care meant they could not be allowed home.
NHS figures show there were more than 18,490 "delayed transfers of care" – people still in hospital despite being fit to leave – between 19 December and New Year's Day, at a cost of just over £4.8m.
The figures underline the serious and growing problem of "bed blocking", when cold weather and winter illness put pressure on space. It highlights how inadequate provision of social care is restricting hospitals' ability to function normally, by reducing the number of patients who can be admitted when A&E staff have decided they need treatment.
Figures from NHS England also show that 13 patients had to wait at least 12 hours on trolleys in one A&E unit before being found beds, another sign of the difficulties hospitals face. Emergency medicine specialists complain departments get "clogged up" because of bed shortages, meaning they are unable to move patients into the rest of the hospital. Both statistics are worse than for the same fortnight in 2012, when 16,515 patients were unable to leave because social care was unavailable, and five spent more than 12 hours on trolleys.
It costs the NHS about £260 a day to keep someone in hospital, so the 18,490 beds occupied by those safe to discharge – thought to be the highest total ever – cost about £4.8m. The figures sparked renewed concern about how council cuts to social care, due to budgets being squeezed, were affecting patients and hospitals. "It is truly sad that this Christmas more older people than ever before were trapped in hospital when they were well enough to be at home with their families," said Andy Burnham, the shadow health secretary. "Rather than rising to the challenge of the ageing society, we are going backwards, and care of older people is getting worse."
The situation was the result of the coalition's "brutal cuts to social care", he said. "Ministers have left hundred of thousands of people without the home-care they need. It is a false economy, as this social-care crisis is piling pressure on hospitals and is a root cause of the A&E crisis."
The charity Age UK also condemned cuts to social care. "The rising number of older people stuck in A&E when, with the right care, they could be at home, is deeply distressing," said Caroline Abrahams, its charity director. "The social-care system is being stripped to the bone, with access to high-quality social care becoming ever more difficult as vital services are withdrawn or reduced."
Many patients, especially the growing number of frail, elderly people who are occupying an increasing proportion of hospital beds, need social-care support – help at home with basic tasks to help keep them independent – to be in place so doctors feel able to release them after they have been treated, for example, for a fall, urinary tract infection or a broken bone. Abrahams said cuts to social care were morally wrong but also made little financial sense: "The NHS will struggle to cope with the increasing pressures brought on by lack of social-care provision unless the system is radically reformed and given adequate funding."
Research last month by the London School of Economics found 483,000 people had either lost their home care support or were no longer eligible to claim it, compared with 2008. A Department of Health spokesman said: "Many patients on trolleys in A&E will actually have begun treatment, rather than be 'waiting'. The latest average waiting time to treatment in A&E is 75 minutes.
"But no patients should experience unnecessary delays and we know the NHS needs to work differently to respond to the changing needs of the ageing population. That's why we want to make joined-up services the norm, not the exception, so more people can be treated closer to home. We are transforming out-of-hospital care by bringing back the link between GPs and their older patients and investing £3.8bn to join up health and social-care services." The Guardian