Delayed discharge or ‘bed blocking’ is currently causing a huge strain on the NHS, with millions of hospital beds being blocked each year by elderly patients that are well enough to be discharged, but may not have the correct support or equipment in place at home to do so.
Statistics from the Department of Health show that each day there are more than 8,500 elderly patients being treated by the NHS that have been on hospital wards for weeks, even though they may be well enough to be looked after at home should they have the right support. In June 2016 alone 115,425 bed days were lost due to delayed discharges, a figure that is just under 80% more than the same period five years ago.
Experts behind the NHS bed blocking studies have forecast a 24% rise in the number of delayed transfer of care beds between now and 2021, with the possibility of costing the NHS up to £3.3billion in total.
The rising number of delayed hospital discharges is affecting the NHS in numerous different ways, including increasing pressure on A&E departments, increased trolley wait times, and an increased number of cancelled operations.
Hospitals handle more than 1.8million A&E attendances each month, with an average of 460,000 of these being classed as emergency admissions.
Saffron Cordery, director of policy and strategy at NHS Providers details how the rise in A&E admissions is affecting the bed blocking crisis by saying “we’re caught in a relentless cycle of record high A&E attendances, increasing emergency admissions and greater numbers of patients who cannot be discharged because the services they need in the community have not been properly resourced yet.”
Figures show that whilst Britain’s elderly population continues to increase, the number of people receiving state care outside of hospitals is falling, putting a huge burden on NHS A&E departments where there are limited beds available.
Newly arrived patients that require a bed are left waiting on trolleys in hospital corridors, with the number of people waiting between four and twelve hours for a bed, almost tripling since 2013.
As a result of the daily delayed discharge of over 8,500 patients, the rise of cancelled operations could be directly linked to the lack of beds available. In efforts to help tackle the bed blocking crisis, nearly 100,000 operations were cancelled on the day during 2015 (Patient’s Association).
Other implications of the escalating figures include an increased delay in assessments, poor cross-departmental communication and the ineffective allocation of nursing home placements. This shows that not only does the situation negatively impact patients, but it has the potential to cost the NHS a considerable amount each day.
If you take into account the 8,500 beds that are being blocked each day and the costs of staff, it is estimated that delayed discharge is currently costing the NHS £900 million a year.
It is, however, thought that this cost could be a lot higher.
A report carried out by Labour peer, Lord Carter, shows the growing trend to pay private hospitals to do NHS work, as well as the growing waiting times in A&E, could also contribute to the overall cost of bed blocking.
Each year there are more than 6.6million ambulance call outs in the UK, 700,000 of which are for falls. Out of those, it is estimated that 45% of people are uninjured and do not need transferring to a hospital.
With that in mind, it is better to provide care and support to patients in care homes or their own home, rather than admit them to a hospital for an assessment. Patient lifting devices like the Mangar ELK and Camel Lifting Cushions can be used to safely lift someone that has fallen, without them having to be admitted to an A&E department.
One solution that is often discussed when it comes to bed blocking is that people who require continuous care may not necessarily need hospital-based care and may need a specialist care environment or care home instead. Although they may not be well enough to stay in their own home without assistance, there are a lot of patients who would benefit more from being in an environment where they can receive a more tailored method of care.
One of the key issues with bed blocking is that there are not enough measures in place to ensure people that are ready to be discharged have the right equipment waiting for them at home. This could be anything from falls prevention to pressure care management.