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Aby Atilola is a product manager with OLM group, she looks after OLM’s commissioning and resource utilisation products. She has a background in developing patient record systems and contract management systems in the utilities sector.

@OLMSYSTEMS

Bed blocking emergency funding may remain unused.

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© Valerie Everett 2006 "to brake use this lever"

Earlier this year the UK government allocated £1 billion to help alleviate the ‘bed blocking crisis’. Some hospital managements claim that many local authorities are not using their allocated funding.

The words “bed blocking” refer to the extended and unnecessary occupation of hospital beds by the frail and/or elderly due to lack of appropriate care and/or care facilities being available once they leave hospital. It is calculated that bed blocking costs the NHS £900 million a year. Include the human costs, stress and unhappiness and you have a crisis that far outweighs the direct financial cost but also contributes to another level of financial cost as the effect of delayed return to the community knocks on.

The reasons for bed blocking are many and complex. But a structural difference is at the heart of the problem. Health care under the NHS is free to all at the point of delivery.  Social care is means tested. Put simply if you go into hospital for medical treatment you will not be presented with a bill. Once you are clinically fit you should leave hospital and, where necessary, be cared for by social care. This social care must either be purchased from your own purse or if you do not have enough money the Local Authority will pay.

The different delivery points of health and social care for those who need it should join up seamlessly. Joining them seamlessly would, it is widely believed, save the nation money. But they don’t. Writing or saying “health and social care” exposes the fundamental fault in the structure. How can healthcare not include a great and extended element of social care? How can social care not affect the health and healthcare needs of those cared for?

The £1 billion allocated by the government is to be shared between all English local authorities. Authorities that top the list for delays are allocated the highest level of funding. If this sounds like being rewarded for poor performance that is because it is exactly what it is. Nevertheless the funding is intended to help local authorities provide care levels (care beds and/or carers to care for people in their own homes) that will allow the NHS to clear the blocked beds and so offer increased capacity to serve the queue of patients in real need of a hospital bed.

There is an overriding need for more care beds, more council funded places in care homes. The reality is that due to austerity levels of funding the number of beds/places available to many local authorities is reducing not growing. There is also an overriding need for more carers but recruiting and keeping carers is getting more and more difficult.

Despite the £1 billion emergency funding more than 40% of hospital trusts say they are not confident that they will have enough beds available to provide appropriate levels of care this coming winter. This means they fear that they will not be able to clear beds quickly enough once the occupants are well enough to leave.

Some hospital managements are claiming that many local authorities are failing to put their emergency funding into moving patients into the social care arena quicker. Chris Hopson, Chief Executive of the NHS Providers Association, says that hospitals, “are approaching the cliff edge” with regard to their ability to provide adequate care next winter. Initial government figures suggested that the £1billion emergency funding would free up between 2,000 and 3,000 hospital beds. These targets seem unlikely to be met. 

NHS hospital trusts say that less than 30% of local authorities believe that the new money will actually help reduce delayed discharges of care. For their own part, 34% believe that this problem is not being given priority by the local authority. It seems likely that a significant amount of the emergency funding will remain unspent as the autumn brings increased demand for hospital beds.

There are two fundamental problems we face, the availability of care beds and carers in the local community, in addition to the speed that the NHS trusts/Councils can shift the people who are ready to move.

There is a sort of paralysis that comes when problems are huge, complex and apparently intractable. Just because the entire problem cannot be fixed at a stroke does not mean that the problem that can be fixed should be ignored especially where the funding is available. Making more care beds available and recruiting more carers is difficult, costly and will take time. But making the best use of the beds that are available is within our grasp. 

The OLM Bedfinder app allows social care and hospital discharge teams to make more efficient use of their time. It reduces the time wasted by staff calling round to Care Homes trying to find a suitable vacancy and allows the user to check for vacancies and reserve the space online. One local authority which piloted the software in their district reported savings of 350 staff days over a six month period.

 

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