One-off payments in order to reduce delays when it comes to hospital discharge happen to come with not so sufficient advance notice for effective planning, thereby forcing providers to go ahead with short-notice residential care but not going ahead with supporting patients at home, as founded by the King’s Fund report.
The report, Hospital Discharge Funds: Experiences of Winter 2022-23, had an in-depth analysis of six health and care systems. The authors went on to discuss with local authorities, leads concerning the integrated care system, acute trusts, Healthwatch, as well as local care provider associations.
It is well to be noted that commissioners as well as providers across each area majorly criticized burdensome tracking requirements and said investment was rarely there so as to safeguard hospital admissions.
There were areas that did manage to make use of the funding so as to put services in place and, at the same time, support social care, but did not have the confidence that they were spending the funding the way it should be.
Notably, the funding in question was offered in two tranches: firstly, the Adult Social Care Discharge Fund of £500m coming from the Department of Health and Social Care, and secondly, a hospital discharge fund of £250m from NHS England. Each happened to have varied conditions, which were unknown in advance, said the authors.
Apparently, the report went in to find out that the six sites did not have a shared understanding when it came to local causes of delayed discharges or the priorities for action. The authors went on to hear the above 20 reasons for delayed discharge, but, interestingly, the lack of staffing happened to be a consistent theme.
The report also went on to highlight NHS England data, which inferred that while many more patients happened to be discharged home simply as seen in 85% of cases vis-à-vis the predicted 50%. Furthermore, three times more patients were looking to have 24-hour bed-based care on discharge, i.e., 3%, as compared with the expected 1%.
Delayed hospital discharge: a long-standing problem
A senior fellow from King’s Fund and also the co-author on the report, Simon Bottery, opined that delayed hospital discharge is indeed a widespread as well as a longstanding challenge that goes on to affect many patients and, of course, their families along with loved ones. The major reasons for delays often happen to be complex and vary between local systems, and the fact remains that workforce issues are often the main cause.
He added that their analysis makes a ground that the Department of Health and Social Care should go ahead with only short-term and ring-fenced funding on an exceptional basis and should make sure of sufficient notice to sites so that they can very well plan for it.
Bottery further said that it is also clear that places should put effort in terms of developing shared understanding when it comes to discharge performance, the causes when it comes to delays, and actionable priorities so as to tackle them, as they had found that these often lacked among system partners.