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Hospital bed-blocking 'costs' NHS England £900m a year Hospital bed-blocking 'costs' NHS England £900m a year
(about 4 hours later)
Delays in transferring patients out of hospital after treatment could be costing the NHS in England £900m a year, an independent review has said. Delays in discharging patients out of hospital after treatment could be costing the NHS in England £900m a year, an independent review has said.
Labour peer Lord Carter's report on how the NHS could save cash said nearly one in 10 beds was occupied by someone who was medically fit to be released. Labour peer Lord Carter's report found nearly one in 10 beds was taken by someone medically fit to be released.
Lord Carter also called for better procurement and staff management and said the drugs bill should be cut. It said it was a "major problem" causing operations to be cancelled and resulting in the NHS paying private hospitals to see patients.
He said the "deliverable" proposals could help save £5bn a year by 2020. Union Unison said cuts to social care were a major cause of "bed-blocking".
Hospitals across England must end "stark" differences in spending and productivity, Lord Carter added. Lord Carter identified the issue in a wider look at how £5bn could be saved by 2020.
His proposals called for better procurement and staff management, and savings to the drugs bill.
But delayed discharges are likely to be prove a more intractable problem as it is largely not down to the actions of hospitals.
Vulnerable and frail patients cannot be released if there is not the support in the community from home care workers or district nursing staff or a place in a care home.
While official statistics suggest about 5,500 patients a day are affected, the report said information provided by trusts estimates as many as 8,500 beds in acute trusts were being blocked.
It highlighted the growing trend to pay private hospitals to do NHS work, such as knee and hip operations, as a consequence of this.
Last year the NHS spent £11bn in the private sector - a rise of 11% on the previous year. Lord Carter said delayed discharges was likely to be a "contributory factor" in this.
Delayed discharges have also been blamed as one of the causes of growing waiting times in A&E as doctors struggle to find beds for patients who need to be admitted.
Meanwhile, Lord Carter said hospitals across England must end "stark" differences in spending and productivity, Lord Carter added.
He found the average cost of an inpatient treatment is £3,500 but said there was 20% variation between the most expensive trusts and the least expensive.He found the average cost of an inpatient treatment is £3,500 but said there was 20% variation between the most expensive trusts and the least expensive.
'Major problem''Major problem'
Lord Carter said: "My experience of the NHS and hospitals internationally is that high-quality patient care and sound financial management go hand in hand."Lord Carter said: "My experience of the NHS and hospitals internationally is that high-quality patient care and sound financial management go hand in hand."
The government-commissioned report described the issue of so-called bed-blocking as a "major problem". Analysis: Savings target is just a start
It happens when there is not the right support in the community to enable them to release patients safely and so is - to a large extent - outside the control of hospitals.
"Nearly all trusts wrestle with the problem of moving those who are medically fit into settings that are more appropriate for the delivery of their care or rehabilitation, and for the families and carers," said the report.
Analysis
By Nick Triggle, BBC health correspondent
Hospitals consume £55bn of health spending - about half the annual budget. So a £5bn efficiency target is very ambitious.Hospitals consume £55bn of health spending - about half the annual budget. So a £5bn efficiency target is very ambitious.
But as a sign of the mountain the health service has to climb in the coming years, consider this: it doesn't even go a quarter of the way to achieving the overall savings the health service is aiming for.But as a sign of the mountain the health service has to climb in the coming years, consider this: it doesn't even go a quarter of the way to achieving the overall savings the health service is aiming for.
In return for the extra £8bn it is getting this Parliament, the NHS has pledged to save £22bn.In return for the extra £8bn it is getting this Parliament, the NHS has pledged to save £22bn.
It means the rest will have to come from people improving their lifestyles (and so preventing ill-health), moving care out of hospitals and into the community (which is cheaper) and keeping tight control on salaries. It promises to be a tough few years.It means the rest will have to come from people improving their lifestyles (and so preventing ill-health), moving care out of hospitals and into the community (which is cheaper) and keeping tight control on salaries. It promises to be a tough few years.
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Lord Carter highlighted the knock-on effect of non-emergency operations, such as knee and hip replacements, being cancelled, because of the delayed transfers, causing the NHS to spend on paying for private hospitals to see its patients.
While official statistics suggest about 5,500 patients a day are affected, the reports says information provided by trusts estimates as many as 8,500 beds in acute trusts are being blocked.
Lord Carter, who published an interim report in the summer, identified the following savings:Lord Carter, who published an interim report in the summer, identified the following savings:
Each hospital has been set its own individual savings targets. These are not being released publicly although the progress trusts make will be monitored.Each hospital has been set its own individual savings targets. These are not being released publicly although the progress trusts make will be monitored.
Ministers said they expected the savings to be made.Ministers said they expected the savings to be made.
Christina McAnea, head of health for Unison, which represents many NHS workers including nurses and paramedics as well as administrative staff, said the report contained many good ideas.
However, she said the report failed to address the lack of social care in the community that was the "main reason why people can't be discharged".
"On average social care has been cut by around 25% and that has an almost immediate knock on effect in the NHS, because you can't discharge patients unless you've got the infrastructure back in the community to support them," she said.
"And that's where we've seen massive cuts, so it's about care workers, some community nursing, it's about health visitors."
Health Secretary Jeremy Hunt said: "This ground-breaking review will help hospitals care for patients, making sure every penny possible is spent on front line patient care and bureaucracy is slashed so doctors and nurses can concentrate on caring."Health Secretary Jeremy Hunt said: "This ground-breaking review will help hospitals care for patients, making sure every penny possible is spent on front line patient care and bureaucracy is slashed so doctors and nurses can concentrate on caring."
Shadow health secretary Heidi Alexander said: "This report is absolutely right to highlight the huge financial pressures that delayed discharges are placing on the NHS. However, ministers cannot shy away from the fact that this is a crisis in care that has happened on their watch."Shadow health secretary Heidi Alexander said: "This report is absolutely right to highlight the huge financial pressures that delayed discharges are placing on the NHS. However, ministers cannot shy away from the fact that this is a crisis in care that has happened on their watch."
The Health Foundation think tank described Lord Carter's proposals as positive but only the tip of an iceberg as NHS leaders had said a total of £22bn of annual efficiency savings were needed by 2020.