UK health leaders question impact of cash on freeing up hospital beds

Health leaders on Monday welcomed a promise by the UK government to spend up to £250mn to speed up the discharge of hospital patients, easing pressure on the country’s struggling NHS, but questioned how much impact funding could have so far into the winter.

Senior medics and NHS workers have in recent weeks voiced alarm over the effect of staff shortages, rising flu and Covid cases and industrial action on patient safety. Officials from the Royal College of Emergency Medicine have estimated that between 300 and 500 deaths occur each week due to delays in emergency care.

Health secretary Steve Barclay said that the government would “block book beds” to speed up the discharge of around 2,500 medically fit patients from hospitals into community settings such as care homes.

Around 13,000 patients in NHS beds in England each day are unable to leave hospital due to a lack of community care, a situation blamed for exacerbating ambulance waiting times.

Around £50mn of the total will be capital funding to improve hospital facilities such as ambulance hubs and discharge lounges. Barclay also announced measures designed to ease pressure on clinicians, and “free up frontline staff from being diverted by CQC [the Care Quality Commission regulator] inspections over the coming weeks”.

He added that from the end of March, pharmacies would take referrals from urgent and emergency care settings.

Saffron Cordery, interim chief executive of NHS Providers which represents health organisations across England, said that health leaders would be seeking “urgent clarification” that the social care funding was genuinely new money rather than being drawn from existing budgets.

Citing delays in distributing money from a separate £500mn adult social care discharge fund announced last September, she demanded assurances from ministers that the £200mn would be distributed immediately.

Nigel Edwards, chief executive of the Nuffield Trust, said Barclay had offered a short-term “sticking plaster” but the fundamental focus needed to be on “creating a more sustainable social care provider system”. 

Sally Warren, director of policy at the King’s Fund think-tank, said it was unfortunate that the pledge had come so late in the winter. The availability of staff would be a key constraint on how many additional beds in care homes could be provided, she cautioned.

Speaking in the House of Commons on Monday, the health secretary expressed “regret” over the “extraordinarily difficult” time for the NHS. He argued that the “scale, the speed, the timing” of the flu season — which he said was the worst for 10 years — alongside a high number of coronavirus admissions had resulted in a “real strain on frontline services”.

However, industry associations highlighted the cost implications for the NHS. They warned that the health service would need to pay up to three times more than local authorities for care beds. The extra money would be required to recruit staff and to deal with the more complex needs of recently discharged patients.

Martin Green, chief executive of Care England, which represents independent social care services in the UK, said local authorities have been underpaying for their services, with some paying as little as £490 per bed per week, which worked out at £2.95 an hour.

He added that if the NHS paid £1,500-£2,000 a week per bed, this would work out as £1,000 a week cheaper than keeping patients in hospital. He warned that £200mn was insufficient to solve the crisis and called for a national tariff to apply across the UK.

Meanwhile in Scotland, first minister Nicola Sturgeon said hospitals north of the border were almost “completely full”. She added that the devolved government would inject extra funding to boost care services in the community to ensure patients were discharged from hospitals quicker.

Hospital bed occupancy across Scotland exceeded 95 per cent last Wednesday, compared with 87 per cent during the same period in 2020. Sturgeon added that more than 1,700 patients were currently in hospital despite being well enough to be discharged, due to a lack of care places.

In addition to increasing staffing for the NHS 24 phone helpline, the Scottish government said it would allow hospitals to make decisions on prioritising “critical and life-saving care”.