Scottish care providers call for reform as postcode lottery for elderly patients revealed
Wide regional discrepancies in the speed with which elderly patients declared medically fit to leave hospital are discharged are exposed in ground-breaking new research by the UK’s largest and most comprehensive later-life care directory, Autumna.
The survey of more than 500 care homes and home care agencies has revealed the best and worst performing regions for speed of discharge from hospital, as well as communication between hospital discharge teams and social care providers, with nine in ten providers calling for reform of the system.
100% of care providers questioned in Scotland want the government to reform the hospital discharge process, regardless of whether or not they receive referrals from it. This reflects that the system is among the worst performing in the country.
42.9% of respondents say they don’t have a positive relationship with hospital discharge teams (34% nationally). Only one in five providers receive referrals at least weekly, suggesting a lack of effective communication which may also contribute to slow patient admission: 50% of providers say discharge from hospital takes more than a week (24.3% nationally), with 14.3% saying it takes three weeks or more (nearly twice the national average).
93% of care providers nationally would like to see government reform of the hospital discharge process, with the figure ranging from 85.7% in the North East to 100% of providers in Scotland. Nationally, 85% of care providers who have a positive relationship with their local hospital discharge teams still want the process reformed.
Full national and regional findings: www.autumna.co.uk/hospital-discharge-report-2024/
“Our survey, which is the first to probe the experiences of social care providers of the hospital discharge system, shows a system that is failing due to poor relationships caused by poor communication,” warns Debbie Harris, the founder and Managing Director of Autumna, which has developed a digital solution to speed up hospital discharge*.
“Our findings are a wake-up call to Kier Starmer and Wes Streeting that the system is broken and urgently needs reforming. The pressures are only going to get worse as our population gets older, so we need to fix the system now, before it completely breaks down,” she adds.
Delayed hospital discharge costs the NHS around £4.8 million a day1. It also results in: worse health outcomes for elderly patients; other patients not being able to access hospital services; and increased pressure on local authorities, as elderly patients who are stuck in hospital end up with greater care needs.
“Autumna’s Hospital Discharge Report: Care Providers’ Perspectives clearly outlines a system that is failing and will only get worse unless remedial action is taken,” comments Professor Martin Green OBE, Chief Executive of Care England.
“However, this report also highlights the fact that there are solutions, and if people worked effectively with the social care sector and gave it the needed resources, the solutions would be easily and readily available.”
Autumna’s research shows that four in ten social care providers do not receive referrals from hospital discharge teams.
“We have elderly patients stuck in hospital when there is sufficient care to support their discharge, either in a care home or with support at home,” comments Harris. “Hospital discharge teams do not have effective tools to identify available, appropriate care quickly and are overly reliant on some providers, meaning elderly patients are denied access to the full range of appropriate support available to get them out of hospital.”
48.7% of care providers do not feel the hospital discharge teams understand the care they offer. A third of providers (33.4%) say they can’t talk to discharge teams when they need to. Of the care providers who do receive referrals from hospital discharge teams, a similar number (34.0%) say they don’t have a positive relationship with them.
17.0% of care providers questioned say the average length of time for discharge into their care after a patient has been declared fit to leave hospital is one to two weeks, while 7.3% say the average length of time is three or more weeks.
The top reasons for delays in patient transfer to social care providers are because the funding is not agreed, there is insufficient information and lack of communication. 45.5% of care providers say information provided by hospital discharge teams is not accurate. 44.6% of care providers think the information provided by hospital discharge teams is insufficient to make an initial assessment on admission suitability.
“The care sector has the capacity, the expertise and the enthusiasm to be part of the solution,” advises Harris. “What’s more, speeding up hospital discharge will help the commercial viability of providers who face increasingly squeezed margins; 518 care homes closed in 20232, with a loss of 14,169 beds2.
More than 15 million people are projected to be over the pensionable age by 20453, with the number aged 85 and over expected to increase by 1 million to 2.6 million over the same period4.
“With an ever-ageing population, continuing to fail to find a solution to speedy, efficient and appropriate hospital discharges is unsustainable – for the NHS, for local authorities, for the taxpayer, and – most importantly – for our elderly,” urges Harris. “We challenge the government, health and social care leaders to think imaginatively to rise to the challenge.”
For a summary of regional discrepancies, see page 4. For full national and regional results, incl. quotes from local care providers, download the full report: www.autumna.co.uk/hospital-discharge-report-2024/
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