3 million hospital bed days lost

Almost three million (2,998,273) hospital bed days have been lost between June 2010 and January 2016 due to a lack of social care provision at a cost of £910 million, according to a new report by Age UK.

Age UK published the alarming figures today, Wednesday 16 March, the day the Chancellor announces his Budget. 

The findings reveal that between just two years (Jan-Dec 2014 and Jan-Dec 2015), there has been a 28.4% increase in the number of hospital days lost due to a lack of social care provision available for people being discharged from hospital.  

This increase came in the first year of the Better Care Fund (from April) when it was hoped that pooled funding would reduce delayed discharges.

Cuts to community health and care services

Cuts to community health and social care services have meant the NHS has wasted bed-days while patients wait for the right care and support in the right place to become available.  

Looking deeper into the issue, there has been a:

• 59.8% increase in bed days lost awaiting a care package at home since 2014 (Jan-Dec 2014: 181,755 days /Jan-Dec 2015: 290,521 bed days lost)
• 13.8% increase in bed days lost awaiting a nursing home placement or availability since 2014 (Jan - Dec 2014: 203,696 days /Jan-Dec 2015: 231,880 days)
• 9.2% increase in bed days lost awaiting a residential home placement or availability since 2014 (Jan-Dec 2014: 167,685 days /Jan-Dec 2015: 183,114 bed days lost)

Age UK's accompanying report: Behind the Headlines, explores the complexities around hospital discharge and looks at the horrible situations often facing older people and their families when it is clear they need follow-up support but none is available.  

Behind the headlines report (PDF, 219KB)

Calls to Age UK's free Advice Line on delayed discharge have almost doubled in the last three years.

The case studies below reflect issues raised over the past six months. Names, gender and certain details and characteristics have been changed to preserve our callers' confidentiality. 

The stories reveal what delayed discharge actually means for some older people and what could happen to any older person and their family and friends. Read more case studies by downloading the report.

• Terry's father Richard, 85, is in hospital following a stroke. He is ready for discharge and has been assessed as needing rehabilitative care through two home visits a day. However he was then told that there are no reablement services available in his area. Terry has been told to ‘get his father out of hospital' and to look for and fund the care himself.
• Paul's wife Mary, 85 years old, is in hospital. She has lost her mobility during her hospital stay. Yesterday the hospital told him Mary was ready for discharge today and she can't occupy a hospital bed anymore. Nobody has assessed what she will need to help her recover at home, whether she can regain her mobility, or what adaptations are available to help them manage. Paul was able to delay the discharge for a day by getting the Patient Advice and Liaison Service involved but he still wasn't given any information about her rights, or about how they are going to manage at home.

Age UK argues that a combination of acute shortages of good health and care services to help older people recover are the main problems behind most delayed discharges of older people from hospital wards. Along with poor co-ordination, buck passing between the NHS and care services, and a lack of information and general confusion about what's available and who is responsible for paying for care.

An NHS bed costs on average £2,121 per week, compared to around £563 for a week in residential care, or £356.58 for home care based on three hours of care a day over the course of one week. 

Age UK's Charity Director, Caroline Abrahams, said: ‘These statistics and our accompanying report describe the slow motion car crash that occurs when you underfund the social care services that allow older people to be safely discharged from hospital - this at a time when demand for such services is constantly rising because our population is ageing.

‘Older people, their families and friends, and the overstretched staff in councils and hospitals trying to keep the system going are all victims of the funding decisions that have been made. So too are the hundreds of thousands of people of all ages who have had to wait longer for hospital treatment because of the resulting shortages of available hospital beds for them. 

'Trapped in nightmarish situations'

‘We show in our report how older people and their families can find themselves trapped in nightmarish situations; under pressure to leave hospital but forced to wait for the care support they need for a full recovery, if indeed this is available at all. Sadly, without it older people may never regain their previous levels of health and fitness. In some cases this means they can no longer live independently, in others that they quickly have to be readmitted to hospital, risking a damaging downward spiral for them all over again. 

‘This awful situation represents a staggering waste of public funds that also hurts vulnerable older people and their families. It is why we believe the Government should urgently look again at the funding being provided for these kinds of services, acknowledge the need for substantially more investment, and take action to plug the all too obvious funding gaps.'

Behind the headlines report (PDF, 219KB)