Five months in a ward as bed blocking bites

Dec 17 2007 by David Higgerson, Liverpool Daily Post

A NEW bed blocking scandal is threatening to engulf the region’s health service as patients spend up to five months in hospital beds unnecessarily, the Daily Post can reveal.

An investigation by the Daily Post into bed blocking – the name given to cases where patients end up staying in hospital because councils can’t provide the right care home or home support straight away – has revealed many patients are waiting months in hospital for appropriate care to be found for them.

As a result, councils in Merseyside and Cheshire are now paying out hundreds of thousands of pounds a year to hospitals in compensation.

In 2003, when the last bed blocking crisis was at its peak, the Government told hospitals to fine councils £100 a day for “delayed discharge” cases, in a bid to make social services departments move more swiftly.

But many hospitals are not charging the full amount, and politicians last night rounded on the policy, saying the new problems showed the solution wasn’t the right one.

Across the region, more than 10,000 “bed days” are being lost each year to delayed discharges – more than half in Wirral – raising concerns among senior managers in hospitals about their reduced ability to meet strict waiting list targets for other patients.

The longest case reported to the Liverpool Daily Post was at University Aintree Hospital, where one patient spent 135 days in hospital unnecessarily. Bed blocking at Aintree’s hospitals cost the trust 3,495 bed days in the 12 months to April.

Replying to the Daily Post’s request for information, an Aintree Hospital spokesman said: "The majority of cases will have been older people.

"The primary reason for these delays is that patients are awaiting a vacancy in a residential care home of their choice."

At hospitals in Wirral, the longest bed blocking case was 67 days, with 5,548 bed days lost over the year.

The Countess of Chester Hospital recorded a single bed blocking case lasting 96 days. It also reported other cases of 65 days and 46 days.

The region’s largest hospital trust, Royal Liverpool and Broadgreen, reported 33 days as its longest individual case – with a total of 1,568 bed days lost in a year.

North Cheshire Hospitals reported it lost 1,455 bed days to bed blocking cases, but added: "Of that, 1,261 bed days were down to patient or family choice in that the destination of choice was not available."

Upwards of £1m has been paid out by councils in the area in the last two years for bed blocking fines.

Hospitals are supposed to charge up to £100 a day to councils which can’t provide appropriate accommodation for patients fit to leave hospitals.

Walton MP Peter Kilfoyle said last night: "What we appear to have lost sight of is the impact of bed blocking on the patient involved.

"Being left in hospital for five months is disgraceful. It doesn’t matter where the money ends up being paid for the care, the fact is that this is an unacceptable situation.

"To lose so many bed days in a year shows the system isn’t working, and we haven’t got a system which is working for the patient."

A spokesman for the Patients Association said: "These delays are really avoidable, they're really unacceptable and unfortunately it's happening to a lot of people. One part of the health system obviously doesn’t know what the other is doing.

"Last year, there was an increase in bed blocking by something like 30% and involving almost 50% of NHS trusts, so it's not isolated by any means. It's extremely worrying."

Gordon Lishman, the Lancashire-based Director General of Age Concern, said: "No one wants to stay in hospital longer than they have to, but it is sadly the case that older patients often have nowhere else to go,

"The NHS and social services have failed to invest adequately in appropriate community services and support, which is leaving it unsafe to discharge some older people from hospital."

Liverpool City Council has paid out almost £400,000 in the last two years.

But, in a statement, the city council said: "The City Council is working more closely than ever before with local hospitals and the Primary Care Trust to continue to reduce the length of time people who are medically fit for discharge have to wait for transfer.

"The Government Minister Ivan Lewis has recently acknowledged the efforts of health and social care workers who have delivered a 5% reduction in bed days lost nationally over the last 12 months. The numbers locally are small at any one time, and we are implementing initiatives with our partners with an aspiration of achieving zero delays.

"It is inevitable that, on occasion, additional time may be required to ensure that the individual receives the right package of home-based care and in such circumstances alternative arrangements to remaining on busy acute hospital wards will be offered to facilitate a safe and timely discharge.

"It should be acknowledged, however, that this money is not lost to the Health and Social Care system as the grant and any payments made are used to develop the system to continue to support safe and timely discharge from Acute Hospital care."

Last night, leaders of the care industry said bed blocking was indicative of a general care crisis within the region, particularly Liverpool.

One source, who did not wish to be named, said: "The problem is, dozens of care homes in Liverpool have been forced to close down because of a lack of funding in recent years, to the point where there are not enough left.

"Liverpool City Council has deliberately failed to support care home owners and have adopted the policy of steering elderly people towards home care packages, which it claims is following Government guidelines.

"They have ignored the fact there will always be a need for a certain number of care homes. We are now in a situation where families cannot find a place for their elderly relative who is in hospital and there is nowhere else for them to go."

davidhiggerson