Into Perspective

Is Government's hospital discharge plan a long-term prospect?

Discharge delays

According to NHS England, an average of 13,440 patients a day remained in hospital in December 2022 despite no longer meeting the criteria to stay. This is 30% more than the daily average for December 2021 (9,150). Government suggests around 24% of patients with delayed discharges are waiting for home care, 16% are awaiting a care home place and 24% are waiting for intermediate care.

Discharge funding

Government’s policy paper ‘Our plan for patients’, published in September 2022, pledged £500m ‘to support discharge from hospital into the community and bolster the social care workforce, to free up beds for patients who need them’. £300m will be given to integrated care boards (ICBs) to improve bed capacity, £200m will go to local authorities and the funding will be pooled into the £500m Better Care Fund.

About the funding to blockbook care home beds, Health and Social Care Secretary, Steve Barclay, said it will facilitate 2,500 people to be discharged from hospitals. This is on top of the 1,000-1,200 delayed discharge cases targeted through the Better Care Fund.

Sector scepticism

In response to Government’s Better Care Fund, The Nuffield Trust argued that it is merely the latest attempt in a long line of insufficient short-term fixes, concluding that ‘the Government’s down payment may prove to be just too small a deposit to prevent this fragile system from crumbling completely.’ Concerning the funding to block-book care home beds, the Health Foundation raised concerns about whether a residential setting would be the most appropriate place for the majority of people being discharged from hospital to further recover, citing the Government’s own guidance that less than 5% of people discharged from hospital will need ‘24-hour bedded care’.

Furthermore, the British Geriatrics Society has suggested that ‘decisions that solve rather than shift problems’ need to be made before the sector can accept that long-term solutions have been proposed. Moral concerns have also been raised by the Association of Directors of Adult Social Services (ADASS) who highlight the ‘risk of people being inappropriately placed and then remaining in residential provision indefinitely’.

In a joint letter to the Health and Social Care Secretary in January 2023, ADASS, the Local Government Association and Solace, stressed that ‘certain conditions need to be in place in order to avoid the approach leading to people spending longer than necessary in care homes and costing the taxpayer more as a result’.

More to come

In the 2022 Autumn Statement, Government committed to investing an additional £1bn of funding in England in 2023-24, increasing to £1.7bn in 2024-25 to get people out of hospital on time and into social care. £600m in 2023-24 and £1bn in 2024-25 will be allocated through the Better Care Fund aforementioned. The remaining £400m in 2023-24 and £680m in 2024-25 will be allocated to local authorities through a ringfenced adult social care grant which will also help to support discharge.