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You can find the current article at its original source at https://www.theguardian.com/healthcare-network/2016/dec/16/social-care-crisis-nhs-trusts
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| The social care crisis is pulling NHS trusts further underwater The social care crisis is pulling NHS trusts further underwater | |
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| The government’s refusal to find any new money for social care will inflict significant and lasting damage on the NHS and the lives of its patients. | The government’s refusal to find any new money for social care will inflict significant and lasting damage on the NHS and the lives of its patients. |
| The local government finance settlement announced by the communities secretary, Sajid Javid, this week did virtually nothing to alleviate the growing social care crisis. He simply allowed local authorities to bring forward council tax increases and shifted £240m from housing. | The local government finance settlement announced by the communities secretary, Sajid Javid, this week did virtually nothing to alleviate the growing social care crisis. He simply allowed local authorities to bring forward council tax increases and shifted £240m from housing. |
| Compare that with Local Government Association figures showing adult social care funding fell from £14.7bn in 2012-13 to £14.1bn in 2015-16, while demand continues to rise. | Compare that with Local Government Association figures showing adult social care funding fell from £14.7bn in 2012-13 to £14.1bn in 2015-16, while demand continues to rise. |
| The government’s refusal to provide any meaningful relief for social services is a blow to the NHS England chief executive, Simon Stevens. Ministers have been unshakeable in their insistence that they have given the NHS more than it asked for to fund the Five Year Forward View transformation plan, a position that Stevens has directly challenged in parliament. With no likelihood of the health service getting more money directly, Stevens had been pushing hard to get additional cash into health and care through social services. That has now failed. | The government’s refusal to provide any meaningful relief for social services is a blow to the NHS England chief executive, Simon Stevens. Ministers have been unshakeable in their insistence that they have given the NHS more than it asked for to fund the Five Year Forward View transformation plan, a position that Stevens has directly challenged in parliament. With no likelihood of the health service getting more money directly, Stevens had been pushing hard to get additional cash into health and care through social services. That has now failed. |
| Safe occupancy levels are now breached routinely, increasing the risk of hospital-acquired infections | Safe occupancy levels are now breached routinely, increasing the risk of hospital-acquired infections |
| The health and care system is now in a stand-off with the government. Downing Street sees constant calls for more money as no more than routine shroud-waving, and suspects that the Sustainability and Transformation Plan initiative will provide more of the same. Javid and the health secretary, Jeremy Hunt, are locked into this position, whatever their private views. | The health and care system is now in a stand-off with the government. Downing Street sees constant calls for more money as no more than routine shroud-waving, and suspects that the Sustainability and Transformation Plan initiative will provide more of the same. Javid and the health secretary, Jeremy Hunt, are locked into this position, whatever their private views. |
| For many trusts, the social care crisis is pulling them further underwater. Managers tell of the equivalent of several wards of patients stuck in their hospital for want of social services. Some trusts are beginning to invest in stepdown care themselves to alleviate the pressure. | For many trusts, the social care crisis is pulling them further underwater. Managers tell of the equivalent of several wards of patients stuck in their hospital for want of social services. Some trusts are beginning to invest in stepdown care themselves to alleviate the pressure. |
| The Nuffield Trust, in its analysis of hospital bed occupancy, points out that delays in discharging medically fit patients from hospital are at a 10-year high. Keeping people waiting in A&E for a few minutes longer than four hours can be headline news, but the scandal of thousands of people being stranded in hospital for days receives far too little political and public attention. | The Nuffield Trust, in its analysis of hospital bed occupancy, points out that delays in discharging medically fit patients from hospital are at a 10-year high. Keeping people waiting in A&E for a few minutes longer than four hours can be headline news, but the scandal of thousands of people being stranded in hospital for days receives far too little political and public attention. |
| Safe occupancy levels are now breached routinely, increasing the risk of hospital-acquired infections and causing patients discomfort and distress as they are shunted from ward to ward. Although high bed occupancy has a number of causes, delayed discharges through shortfalls in social care are a substantial factor. | Safe occupancy levels are now breached routinely, increasing the risk of hospital-acquired infections and causing patients discomfort and distress as they are shunted from ward to ward. Although high bed occupancy has a number of causes, delayed discharges through shortfalls in social care are a substantial factor. |
| Dangerously high bed occupancy breeds a sense of crisis in a hospital, with temporary beds being set up, staff being redeployed, and the daily, unwinnable battle to get people in and out of a ward distracting nurses from patient care. For A&E staff, the difficulty of getting patients on to wards creates yet more stress. | Dangerously high bed occupancy breeds a sense of crisis in a hospital, with temporary beds being set up, staff being redeployed, and the daily, unwinnable battle to get people in and out of a ward distracting nurses from patient care. For A&E staff, the difficulty of getting patients on to wards creates yet more stress. |
| But ultimately the issue is not budgets or bed occupancy rates, it is the human rights and welfare of thousands of mainly elderly people forced to stay in hospital against their will. Delayed discharge is not merely an inconvenience; it can be life-changing. | But ultimately the issue is not budgets or bed occupancy rates, it is the human rights and welfare of thousands of mainly elderly people forced to stay in hospital against their will. Delayed discharge is not merely an inconvenience; it can be life-changing. |
| Each day in hospital can chip away at a person’s confidence in their ability to return home and live independently. Continence management in hospitals is often poor, causing people to acquire another – and particularly distressing – condition even as they are being treated for a different one. Disorientation increases the longer people are away from their own homes, particularly if they have dementia. | Each day in hospital can chip away at a person’s confidence in their ability to return home and live independently. Continence management in hospitals is often poor, causing people to acquire another – and particularly distressing – condition even as they are being treated for a different one. Disorientation increases the longer people are away from their own homes, particularly if they have dementia. |
| So, too often, the inability of the health and care system to get people out of hospital as soon as they are ready, and get them back in their own homes with the right support, means a substantial reduction in their quality of life. Too often this includes a move to a care home that should never have happened. | So, too often, the inability of the health and care system to get people out of hospital as soon as they are ready, and get them back in their own homes with the right support, means a substantial reduction in their quality of life. Too often this includes a move to a care home that should never have happened. |
| Elderly patients stuck in hospital are the unwitting hostages in the battle for money between the government, the NHS and local authorities. The prime minister and chancellor’s unbending approach to health and care funding is being played out in the deterioration in the quality of life of thousands of mainly elderly people. | Elderly patients stuck in hospital are the unwitting hostages in the battle for money between the government, the NHS and local authorities. The prime minister and chancellor’s unbending approach to health and care funding is being played out in the deterioration in the quality of life of thousands of mainly elderly people. |
| Join the Healthcare Professionals Network to read more about issues like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views. | Join the Healthcare Professionals Network to read more about issues like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views. |