Politics

Beds in residential homes to be block-booked by government so 2,500 hospital patients can be released

The health secretary has announced the government will block-book beds in residential homes so around 2,500 people can be released from hospitals when they are medically fit to be discharged.

Steve Barclay gave a statement to the Commons outlining the plans to help ease the “severe pressures” on the NHS – hours after his talks with unions to stop strikes ended in failure.

He admitted the “experience” for some patients and staff in emergency care has not been “acceptable” in recent weeks.

He said the recovery of the health service falls into three main categories:

• Taking action over the immediate pressures now
• A wider response to give better resilience in the summer and autumn
• Prevention – treating more conditions away from hospital and in the community

To tackle pressures now, Mr Barclay said the government will block-book thousands of care home beds in England to “free up” capacity in hospitals, costing £200m.

SNP leader Nicola Sturgeon announced a similar plan this morning as she revealed hospitals across Scotland are “almost completely full”.

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To increase capacity in A&E, Mr Barclay said the government will introduce “modular units” costing £50m to expand the space available.

The health secretary told MPs the number of people in hospital with flu “this time last year was 50”, whereas this year, “it was over 5,100” – as he once again sought to blame the NHS pressures on flu, COVID and Strep A.

Health leaders have previously criticised this line from the government, saying the “fundamental problem” is the workforce shortage.

There are around 132,000 vacancies in the NHS and 165,000 across social care, about the same size as the population of Newcastle.

Read More:
Workforce the size of Newcastle needed to ease ‘gridlocked’ health and care system

Shadow health secretary Wes Streeting called the solutions announced today “sticking plasters” and said there needs to be more staff in both the health and care sectors, better pay, more training and more investment in primary care so people can access GPs.

He said “everyone knew” the NHS would come under pressure this winter and the plans today are “simply too little, too late”.

“After 13 years, this just isn’t good enough. The prime minister might not rely on the NHS, but millions of ordinary people do, and they are sick and tired of waiting,” he said.

The statement comes after Mr Barclay failed to prevent further strikes in the NHS as talks with union bosses broke down.

Despite the prime minister saying he was “happy to talk about pay” – in what was seen as a breakthrough – Unison said there were no “tangible concessions” which would enable Wednesday’s ambulance strikes to be called off.

The Royal College of Nursing (RCN) said ministers “have a distance to travel” to avert its second-ever set of strikes on 18 and 19 January, while Unite said any suggestion that a one-off pay reward could be made in exchange for a boost in productivity was “absolutely ludicrous”.

And physiotherapists also said they would be announcing strike dates later this week despite the talks.

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Sara Gorton, the head of health at Unison – has said strikes in the NHS will continue as there were no breakthroughs on pay

Mr Streeting said the strikes could have been avoided if Mr Barclay “had just agreed to talk about pay” with the nurses, but instead of “serious talks” earlier today, he offered “45 minutes of lip service”.

The action comes at a time when health leaders say the NHS is coming under greater pressure than it was during the peak of pandemic.

Many hospitals are struggling to free up beds, with the situation exacerbated this winter by factors such as high levels of flu and rising COVID cases.

About 13,000 people in English hospitals are well enough to be discharged but still need some care before they can return to their own home.

Buying spare beds won’t address long-term issues driving winter crisis

The government has been talking for weeks about delayed discharge as being the one of the key drivers for the winter NHS crisis.

There are some thirteen thousand patients in English hospitals who are technically, medically fit for discharge.

That means thousands of patients, potentially in corridors or ED bays, will have to wait longer for a bed and ambulances bringing sick patients to hospital will stack up waiting to discharge their patients as their is nowhere for them to go.

It is a recognition of the failure to address a broken social care system, which when properly funded and staffed, takes the pressure off acute hospitals – both by rehabilitating patients and by preventing them from presenting at hospital in the first place.

Steve Barclay estimates the move will allow some 2,500 patients to leave hospital. On the face of it, it seems like a practical solution.

But the danger is that this fails to take into account the ongoing medical needs of these patients.

According to Professor Alison Leary, an expert on healthcare and workforce modelling, most of the people stuck in hospital are not waiting solely for social care packages. Her data tells her that around 60% need ongoing acute care and a 15% need end of life care.

The government would argue care or nursing homes would be well equipped to look after these patients, but we have lost around half of our district nurses, the people who deliver or oversee these packages, in the 8 years before the pandemic

Help leaders have described the package as “too little too late”.

They say they have been sounding warnings about this winter as early as last year. And they want assurances that this is new funding and not money that is being drawn from existing NHS budgets.

There are also questions about the speed at which these emergency payments can be accessed.

Some health analysts say only 40% of the £500 million adult social care discharge fund announced in September has been released to the NHS and local authorities. The rest will be released in late January. The concern is these non-recurring payments fail to deliver intended results.

Buying up spare social care beds will create much needed capacity: some senior doctors had been calling for an intervention exactly like this one.

But the fear is that this a short term measure that does nothing to address long standing issues affecting health and social care and driving this winter crisis.

In his Commons statement, Mr Barclay said other measures the government will be taking include reducing inspections by the Care Quality Commission in the coming weeks to free up staff, and opening up more routes for patients to get free treatment in the private sector.

To make the NHS more resilient for next summer and winter, he said the government will “capitalise on the potential” of virtual wards, where patients can be “treated at home with technology and wrap around care”.

But “to break the cycle” of the NHS coming under increased pressure, he said there needs to be more done before people end up in hospital.

He said there will be a review in social care of how to help residents at home rather than taking them into hospital, such as when they have a fall.

“We have to treat patients earlier within the community… to give the right support to people where they are,” he said.

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