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| Nursing shortages fuelling delayed discharge from hospital | Nursing shortages fuelling delayed discharge from hospital |
| (6 months later) | |
| Falling number of district and other community nurses as big a factor as social care blockages, analysis finds | |
| David Brindle | |
| Thu 20 Jul 2017 09.12 BST | |
| Last modified on Wed 20 Sep 2017 23.05 BST | |
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| There is no doubt that delays in arranging follow-on social care are causing more older people to be stranded in hospital. But a new analysis of the problem says shortage of district nurses is at least as big a factor. | There is no doubt that delays in arranging follow-on social care are causing more older people to be stranded in hospital. But a new analysis of the problem says shortage of district nurses is at least as big a factor. |
| The number of district nurses in the UK has plummeted by 44% since 2010 when counted as full-time jobs, according to the analysis of NHS data by consultancy Christie & Co (pdf). | The number of district nurses in the UK has plummeted by 44% since 2010 when counted as full-time jobs, according to the analysis of NHS data by consultancy Christie & Co (pdf). |
| The trend is described as a “key trigger” of hospital admissions of older people and of subsequent delayed discharge. District and other community nurses play a crucial role in treating people in their own homes or in care homes when they might otherwise be referred to hospital. | The trend is described as a “key trigger” of hospital admissions of older people and of subsequent delayed discharge. District and other community nurses play a crucial role in treating people in their own homes or in care homes when they might otherwise be referred to hospital. |
| Since 2008, numbers of people aged 60 and over admitted to hospital have soared 65%, the analysis finds. | Since 2008, numbers of people aged 60 and over admitted to hospital have soared 65%, the analysis finds. |
| Michael Hodges, head of care consultancy at Christie & Co, says ministers are missing the bigger, more complex picture behind delayed discharge by focusing narrowly on blockages in the social care system. | Michael Hodges, head of care consultancy at Christie & Co, says ministers are missing the bigger, more complex picture behind delayed discharge by focusing narrowly on blockages in the social care system. |
| “We need to take a much more rounded view of the whole health and social care system,” he says, “including workforce planning for essential roles like district and community nurses and a proper assessment of what more social care providers could offer to ease pressure on hospitals.” | “We need to take a much more rounded view of the whole health and social care system,” he says, “including workforce planning for essential roles like district and community nurses and a proper assessment of what more social care providers could offer to ease pressure on hospitals.” |
| According to a breakdown of delayed discharge figures by Christie & Co, some of the areas said by the NHS to have the worst problems have ample capacity in local care homes to accept older people from hospital for short-term “reablement”. | According to a breakdown of delayed discharge figures by Christie & Co, some of the areas said by the NHS to have the worst problems have ample capacity in local care homes to accept older people from hospital for short-term “reablement”. |
| Homes in Birmingham, which is said to have the biggest delayed discharge challenge, are shown to be operating at only 77.5% capacity. Those in Hampshire, which is said to have the second most severe problem measured by number of days of discharge delays, are running at 84.2%. | Homes in Birmingham, which is said to have the biggest delayed discharge challenge, are shown to be operating at only 77.5% capacity. Those in Hampshire, which is said to have the second most severe problem measured by number of days of discharge delays, are running at 84.2%. |
| “There are great opportunities – and not just for a quick fix,” says Hodges. “I really hope that somehow the politicians look at it properly and strategically for the long term.” | “There are great opportunities – and not just for a quick fix,” says Hodges. “I really hope that somehow the politicians look at it properly and strategically for the long term.” |
| The analysis includes a survey of fees paid to care homes for state-funded residents by 123 English councils, four in five of the total, plus figures for fees charged by more than 200 care providers. | The analysis includes a survey of fees paid to care homes for state-funded residents by 123 English councils, four in five of the total, plus figures for fees charged by more than 200 care providers. |
| On average, “base” fees offered by councils are shown to have increased by 3%-4% this year. But providers have been able to negotiate better terms for care of older people, with an average uplift of 5.2%. | On average, “base” fees offered by councils are shown to have increased by 3%-4% this year. But providers have been able to negotiate better terms for care of older people, with an average uplift of 5.2%. |
| By contrast, fees for “specialist” care such as learning disability or low-secure accommodation have risen by only 1.9% on average – the second successive year to show such disparity. | By contrast, fees for “specialist” care such as learning disability or low-secure accommodation have risen by only 1.9% on average – the second successive year to show such disparity. |
| Hodges says providers are starting to think twice about investment in specialist care and suggests policymakers need “urgently” to look at funding for this part of the social care sector. | Hodges says providers are starting to think twice about investment in specialist care and suggests policymakers need “urgently” to look at funding for this part of the social care sector. |
| The survey confirms a continuing trend of care home providers squeezing self-funding residents, with an average fee increase of 6.3% for private payers and as big a rise as 9.8% in one case. | The survey confirms a continuing trend of care home providers squeezing self-funding residents, with an average fee increase of 6.3% for private payers and as big a rise as 9.8% in one case. |
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| If you’re looking for a social care job or need to recruit staff, visit Guardian Jobs | If you’re looking for a social care job or need to recruit staff, visit Guardian Jobs |
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