Older patients who don’t need to be in hospital ‘cost NHS £1bn a year’

National Audit Office report finds the number of bed ‘days lost’ due to delayed transfers of care has increased by 31% from 2013 according to official data, but the authors suggest the figure may actually be much larger

Difficulties in staffing problems across the health and care sector are causing delays the report found (2011 Getty Images)

The number of older patients being left in hospital when there is no medical reason for them to be there has jumped by an “alarming” 15 per cent in a year and is now costing the NHS almost a billion pounds a year, an official study will reveal.

The report, by the National Audit Office, found that the number of reported hospital bed “days lost” due to delayed transfers of care was now 1.15 million, an increase of 31 per cent from 2013.

But the authors called into question the official data and suggested the figure may actually be much larger. They estimated that it could be as high as 2.7 million “bed days” a year.

The report said the main drivers for the rise in delayed discharge were people waiting longer for home-care packages or nursing home places. The authors pointed out that local authority spending on adult social care has reduced by 10 per cent in real terms since 2009-10.

Difficulties in staffing problems across the health and care sector are another cause of delays, they added.

Vacancy rates for nursing and home care staff were also up to 14-15 per cent in some regions, and less than half of hospitals felt they had sufficient staff trained in the care of older patients

While hospitals are financially incentivised to reduce discharge delays, there is no similar incentive for community health and local authorities to speed up receiving patients discharged from hospital, they added. Delayed discharge is costing the NHS around £820m a year.

The NAO called on the Department of Health, NHS England and NHS Improvement to set out how they will break the trend of rising delays against the challenge of the growing number of older people in the population.

They pointed out that longer stays in hospital could have a negative impact on older patients’ health as they quickly lose mobility and the ability to do everyday tasks.

“The number of delayed transfers has been increasing at an alarming rate but does not capture the true extent of older people who should not be in hospital,” said Amyas Morse, head of the National Audit Office.

”While there is a clear awareness of the need to discharge older people from hospital sooner, there are currently far too many older people in hospitals who do not need to be there.

“Without radical action, this problem will worsen and add further strain to the financial sustainability of the NHS and local government.”

Barbara Keeley, shadow minister for care said delayed discharge was a crisis that could no longer be ignored.

“Over the past six years we have seen an increasing number of frail, older people reaching crisis point, going to A&E and getting stuck in hospital because they can't get the care they need at home or in the community,” she said.

“This isn't good for them and it isn't good for the long-term sustainability of the NHS.

”This is a crisis that ministers can no longer afford to ignore. We need to see urgent action to repair the damage done to care services and to support people to live well in old age.“

Izzi Seccombe, the Local Government Association's community wellbeing spokeswoman, added: “Getting people out of hospital more quickly and back living at home will only work properly if councils get enough resource throughout the whole year to properly fund adequate provision of care services.

“While measures announced late last year for social care go some way to addressing the problems facing adult social care funding, concerns remain that future years will still be extremely challenging, particularly until 2018. That is why the LGA continues to call for £700m of the funding earmarked for social care through the Better Care Fund by the end of the decade to be brought forward now, to ease the severe strain on services supporting the elderly and vulnerable.”

A Department of Health spokesman said: “Elderly patients should never be stuck in hospital unnecessarily and we are determined to make health and social care more integrated. As well as funding the NHS's own plan for the future with £10bn, we are giving local authorities access to up to £3.5bn extra for adult social care by 2019-20."