LGA responds to latest delayed discharges figures

“No one’s elderly parent, grandparents or friends should be left unnecessarily in a hospital bed, when they could be treated in the comfort and dignity of their own home.”

Responding to delayed discharges figures for February 2017 published today by NHS England, Vice Chair of the Local Government Association’s Community Wellbeing Board, Cllr Linda Thomas, said:

“No one’s elderly parent, grandparents or friends should be left unnecessarily in a hospital bed, when they could be treated in the comfort and dignity of their own home.

“Councils are absolutely committed to reducing the level of delayed transfers of care from the NHS and are working with providers and hospitals to help reduce pressures on health services.

“Across the country nearly six out of 10 people delayed in hospital are unable to leave because they require further NHS services, with around a third awaiting support from council social care.

“The scale of underfunding councils have faced in recent years is placing the care provider market under huge pressure, making it more difficult to discharge people from hospital back to their homes and communities.

“But while reducing delayed transfers of care is a significant challenge for both councils and the NHS, this is by no means the only issue facing health and social care, and it’s important it does not become the basis for which overall performance is judged.

“The LGA has worked hard to highlight the significant pressures facing adult social care and secure desperately-needed new government funding for the system. It also works to support member councils tackle these challenges, for example working with local care providers to ensure there are out of hospital beds to meet needs, and using telecare to better support people to recover in their own homes.

“The new funding for social care and the £2 billion announced over the next three years in the Budget is a significant step towards helping councils plug some of the social care funding gaps they face in the coming years.

“However, short-term pressures remain and they further emphasise the need to reform and fully fund the current social care system and find a long-term solution to the social care funding crisis.

“The Government’s Green Paper provides the opportunity to begin a much-needed meaningful national conversation about how, as a society, we should best support people of all ages with care and support needs in our communities.”

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Who pays for social care?

Most people agree the UK needs to do better at providing social care. Some think it is just a case of increasing the money to pay for it by more than it has been increased in recent years. Others say there needs to be reform of the way public sector care is organised and provided. Underlying the debate are two major issues which need discussion.

The first is how much should the state pay and how much should the individual pay? The tripartisan approach for many years has been to say healthcare should be free, but living costs are down to the individual. If the individual has little capital or private pension income, then the state will pay the living costs as well.

Some say the state should take care of more of the living costs of more people. This would require substantial tax rises to meet the bills. It would mean that instead of selling the old person’s home when they move into residential care to pay the living cost bills, the money from the estate would be preserved and pass to the children. People ask why is it fair that someone who has saved and been careful all their active lives has to pay their own living costs, whereas someone who has lived beyond their means will be paid for?

Others say the current system is fine in this respect. If someone is well off, why shouldn’t they use their own assets and income to pay for their living costs? If someone cannot afford a reasonable standard of accommodation and food, don’t we have a duty to be good neighbours and to help pay? This is a cheaper solution for taxpayers.

The second issue is internal to government. At the moment central government pays for and runs the NHS, whilst local government pays for and runs much of the social service provision. It is true local government relies heavily on national government grants paid for out of national taxes, but local taxes have a part to play in financing social care.

Many people like the idea of devolution of power over policy and spending to Councils from Whitehall, yet when problems emerge in a local service the cry often goes up for government intervention. Quite often it is easier to blame the government for alleged underfunding, than to blame individual Councils for poor or unduly expensive provision.

The public is generally not much exercised over who runs the service. They want a good outcome. The main problem with Councils running care and the NHS running health treatments comes at the borders. An elderly person who has been treated in a hospital often needs improved care services in order to be able to return home.

Some Councils are reluctant to commit in a timely and sufficient way to the need to provide social care. The elderly person then remains in a very expensive hospital bed. This costs the state more overall. Someone no longer needing treatment occupies a bed needed for someone who does require treatment. It is often against the wishes and interests of the patient, who wants to get home.

Any thoughts on what reforms are needed?