A rare good news story for health and social care in England
is a great place to pick up an infection, become depressed or get out of shape. Unless you need urgent care, it is not a great place to spend time. Officials in charge of the National Health Service therefore keep a close eye on delayed transfers of care, or, people sometimes known as bed-blockers, and officially counted as those who remain in hospital having been given the all clear to leave.
Helen Buckingham of the Nuffield Trust, a think-tank, says the turnaround is the result of “a burning platform and burning ambition”. With hospitals falling far behind accident-and-emergency targets, managers want to improve things at the other end of the pipeline—those leaving hospital—so doctors’ time is not wasted on people who should be in social care. A recentEngland, instructed the health service to get on top of the issue.
The health service has been helped by a dose of extra funding for adult social care, which was hit hard by austerity. At the spring budget in 2017, Phillip Hammond, the then chancellor, announced £2bn more for such care, with strings attached over how it was spent, forcing collaboration between local authorities and health-care providers. Insiders admit results have been mixed, with some councils using the money to boost their bottom line, but say that it has supported innovation.
These days, people are more likely to be discharged before their care needs are assessed, rather than assessed before they are sent home. That sounds like a ruthless way of clearing wards, but once somebody is home it is easier to work out whether they need help with, say, making breakfast. In Dorset patients are monitored at home through “virtual wards”, in which a team of social workers, doctors and nurses keep tabs on patients, with visits when necessary.
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