Call for extra social care funding after worst-ever NHS England discharge figures

London should take control of its health and social care budget and have a health commissioner to help the mayor coordinate policy, the report argues.

Councils and care bodies have called for millions in extra social care funding to be urgently brought forward after the number of patients whose discharge from hospital was delayed hit the worst-ever level in January.

Figures from NHS England show there were 5,799 patients who were medically fit to leave hospital but who could not be discharged because of a lack of suitable care options as of midnight on the last Thursday of January. This is the highest figure for the last Thursday of a month since figures started in August 2010.

There were 159,089 delayed days in January 2016, up from 150,392 in January 2015. This was the second highest total since monthly data was first collected.

The data also showed there were 1.9m attendances at A&E in January, up 10.1 per cent on a year earlier.

Some 88.7 per cent of patients were admitted, transferred or discharged from A&E within four hours of arrival, well below the 95 per cent target set for hospitals and the lowest performance since records began in 2010.

There were 484,568 emergency admissions in January, 4.6 per cent more than in January 2015.

Elsewhere, 69.9 per cent of Red 1 ambulance calls were responded to within eight minutes, the eighth month in a row that a target of 75 per cent has not been met. The response rate for Red 2 calls was 63.3 per cent. The target has not been hit for this category since January 2014.

Responding to the figures, the Association of Directors of Adult Social Services and Care England said almost one in three delayed transfers of care - 32.3 per cent - was solely down to "unprecedented" pressure on social care. They have issued a joint call for £700m in funding promised for the Better Care Fund for 2019-20 to be brought forward to next week's Budget.

It added that figures from think tank ResPublica show that delayed discharges are expected to cost the NHS £3.3bn over the next five years, yet it would cost just £835m to look after the same patients in an appropriate residential care setting.

Ray James, president of ADASS, said: "More people are now living longer, with increasingly complex needs, while adult social care budgets have been cut by £4.6bn in the last five years. There can be no getting away from the simple truth that the demand for and cost of providing social care significantly exceeds the money being made available by Government.

"The Government has promised more money but it is too little and too late. Unless the Government addresses the chronic underfunding of adult social care - and quickly - many services will be at significant risk over the next couple of years, with worrying consequences not only for the NHS, but most of all for older and disabled people, their families and carers. While by no means a complete solution, bringing forward the new funding currently planned for the end of this parliament would go some way to alleviating this immediate pressure."

Professor Martin Green, chief executive of Care England, added: "Independent care providers have capacity now to support quality care for people on discharge from hospital. It makes no sense for people to be kept waiting in hospital, which is not good for their wellbeing or cost-effective for the health system. Let's put the necessary funding into social care, where it can be best used to meet the needs of people in our communities immediately and address this constantly rising number of delayed transfers."

The Local Government Association has also repeated its call for the £700m Better Care Fund cash to be brought forward.

"No one's elderly parent, grandparents or friends should be left unnecessarily in a hospital bed, when they could be cared for in the comfort and dignity of their own home," said community wellbeing spokesperson Cllr Izzi Seccombe.

"This will only work if local government gets enough resource throughout the whole year to properly fund adequate provision of care services. This is no longer a winter pressure but a whole-year challenge to ensure that the entire health and social care system is able to cope with the increased demand on the NHS.

"While recent measures announced for social care will go some way to addressing the problems facing adult social care funding, concerns remain that future years will still be extremely challenging, particularly the next two."

Janet Morrison, chief executive of charity Independent Age, said: "This January saw ambulance response targets missed for the eighth month in a row, the worst performance against the A&E waiting times target since data was first collected in August 2010 and the highest number of healthy patients stuck in hospital beds in any month since August 2010.

"It is taking longer to get patients to hospital, they are waiting longer once they are there and are more likely to be stuck in a hospital bed because support is not in place to discharge them. As the largest group of service users in the NHS, older people are going to feel the impact of these failures.

"The financial pressures and demographic challenges facing the NHS and social care are only going to get worse, but we've heard no convincing answers from Westminster for how this decline in performance will be halted. That is why we support calls for a cross-party, independent commission on the future of health and social care in this country."


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