NEW figures have highlighted the issue of patients taking up beds at Dorset County Hospital despite being fit enough to leave - as concerns grow over a social care crisis.

More than 60 patients deemed fit to leave Dorset County Hospital failed to be discharged on one day last week, figures reveal. Local clinicians are now appealing to relatives who can play a key part in helping loved ones to leave hospital, as the NHS and social care enter an "extremely difficult" winter.

Charity the Health Foundation said hospital discharge delays impact the entire health and social care system, while reducing the NHS’s capacity to tackle the huge backlog caused by the pandemic.

NHS England data shows 84 patients at Dorset County Hospital NHS Foundation Trust were eligible for discharge on December 12 – the latest available data.

However, only 18 left hospital that day, meaning 66 continued to occupy a bed.

The figures include 34 patients deemed fit to leave who had been in hospital for at least three weeks on December 12 – none of whom were discharged that day.

Dorset Clinical Commissioning Group (CCG) added that as soon as a person is medically ready to leave hospital, they should be discharged home – or to a local care home or community hospital, if that is more appropriate – and assessed to see if they require additional support to aid their recovery.

 

The number of people remaining in hospital beds at DCH on December 12 was was lower than on the same day the previous week, however, when 74 patients failed to be discharged.

Relatives are being urged to support "stretched" NHS and local health and social care services.

Professor Alastair Hutchison, chief medical officer at Dorset County Hospital NHS Foundation Trust, said: “We know that for older people who have recovered to the point of not needing further medical care in hospital, a prolonged delay in discharge can result in what’s called ‘deconditioning’ where immobility and inactivity causes muscle weakness, walking difficulty and increased risk of falls and fractures.”

“Clearly not all friends and relatives will be in a position to support their loved ones in this way, but where they can do, it would make a real difference to their recovery and help the hospital to manage other emergencies as well.”

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It comes as recent reports revealed staff shortages in adult social care - with Dorset Council stepping up its recruitment drive, and issuing a plea for care workers to be added to the Shortage Occupation List and the salary threshold for immigration be reduced.

As reported, Dorset's care sector remains under pressure with staff leaving – and still has three per cent of care home staff unvaccinated.

Councillor Peter Wharf, Dorset Council’s portfolio holder for Adult Social Care and Health, said: “The families and friends of residents, who unfortunately have to go into hospital are going to be so important this winter.

Residents who are medically well enough to be discharged from hospital may need some additional help when they return home.

“By being the someone who is there to make sure they have provisions, a hot meal, something to drink, and are taking any prescribed medication, will not only help their loved one get well in their own environment, but will help another Dorset resident who needs a hospital bed.

“This will also mean precious care resources are being used by those who are most in need.”

“All services will be working hard this winter to make sure everyone who needs medical attention in hospital can be, and family and friends of a discharged resident will play a vital part of the process and we thank you for it.”

The national picture

Across England, around 11,000 patients – 69 per cent of those ready for discharge on December 12 – continued to occupy a hospital bed.

The data covers adult patients staying in acute trusts with a major A&E department, including those being treated for Covid-19, but excludes maternity patients and children.

Patients eligible for discharge on any one day may have been assessed at an earlier date.

Tim Gardner, senior policy fellow at the Health Foundation, said issues stem from a lack of suitable capacity outside acute hospitals.

He said: "Problems with discharges often lead to problems admitting patients to wards from A&E departments, which in turn causes delays in ambulance handovers and can affect the ability of the ambulance service to respond to new emergencies.

"Patients who no longer require acute care may still need a combination of social care or non-acute NHS care in the community, but a lack of support following discharge means too many remain in hospital for longer than necessary.

"Reducing these longer stays would help to alleviate pressures on hospitals, creating capacity that could be better used to address the backlog of care built up during the pandemic."

He added staff shortages were also playing a part and a system overhaul was required to address the problems.

Professor Stephen Powis, NHS national medical director, said staff are going "above and beyond", looking after thousands of Covid patients, while also delivering hundreds of thousands of coronavirus jabs.

He added: "No one wants to spend more time in hospital than needed, and local NHS services are continuing to work closely with social care providers so patients can be discharged when they’re fit to leave.

"So as the NHS once again ramps up to deal with what is going to be an incredibly challenging winter, the best thing you can do to help is to come forward and get your jab."

What can I do to help my relative?

As health and social care services continue to be stretched due to the ongoing pandemic, the role of relatives in supporting patients is very highly valued.

This could include providing some personal care for their relatives in their home, including looking after them during the initial period after they have left hospital.

This could mean including support with shopping, administering medication, changing dressings, meal preparation, checking on their welfare and wellbeing by having regular contact with them particularly following discharge from hospital.

As well as relatives, friends and neighbours can also play a valued role in supporting people in the local community.

Relatives are being signposted to resources to help assist them if they are supporting loved ones once they have been discharged from hospital.

These include:

https://www.mylifemycare.com/article/6307/Leaving-hospital

Discharge_from_hospital_and_recovery_at_home_-_information_for_patients.pdf (dorsethealthcare.nhs.uk)