Thousands of elderly people trapped in hospital by lack of home care

More than 4,000 elderly people are trapped in NHS hospitals on any day, even though they are fit to leave, because they cannot get support at home, a report says today.

One third of them, about 1,300 people, remain in hospital for more than a month longer than necessary, blocking much-needed beds, because of the lack of facilities in the community. The National Audit Office (NAO) says the shortage of care home places is the biggest problem. The position is better than it was a year ago – down from 5,700 patients awaiting discharge – but "more needs to be done" to meet the Government's target of ending delays by 2004, it says.

The finding was seized on by opposition parties who said government plans to penalise local authorities who were unable to cope with discharged patients were misconceived and would make matters worse.

Sir John Bourn, head of the NAO, said: "Many tens of thousands of older people each year find themselves unable to leave hospital, even though their treatment has been completed. This significantly reduces their quality of life and undermines the ability of hospitals to treat more patients and meet testing targets."

The biggest cause of delays was the length of time it took to carry out a "needs assessment" and this was often because of a shortage of skilled therapists. There were signs of better co-operation between health and social care organisations but there had been only limited use of new opportunities to integrate services or establish care trusts.

Edward Leigh, chairman of the Commons Public Accounts Committee, said: "It is intolerable that on any given day 4,000 older people who have finished their treatment are left trapped in hospitals simply because the public services cannot get their act together. The NHS can ill afford to devote its hard-pressed resources to housing patients simply because they have nowhere else to go."

The Liberal Democrat spokesman on older people, Paul Burstow, said: "This report shows that ministers' obsession with targets is perverting clinical priorities. The fines system that Alan Milburn is fanatically pursuing has received yet another nail in its coffin. It is time for the Delayed Discharge Bill to be scrapped." He said that instead of fines, long-term investment was needed in the care system.

The Department for Health said it had made progress in tackling the problem and had cut the number of patients awaiting discharge by more than 1,500 in the past year.