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Prediction of care home meltdown turned into terrifying reality
February 12, 2003 12:00 AM
Commenting on the damning NAO report into delayed discharge that found that the main reason for older people not being discharged is that demand for care beds is exceeding supply and that the fines system will lead to perverse incentives on Local Authorities and Trust to put people in the most readily available, rather than the most appropriate type of care, Liberal Democrat Spokesman on Older People, Paul Burstow MP said:-
"It is now official. For thousands of older people the predictions of a meltdown in the care home sector have become a terrifying reality. The collapse in the number of care homes is stopping vulnerable older people from getting the right care, in the right place, at the right time.
"This report shows that Ministers obsession with targets is perverting clinical priorities. The fines system that Milburn is fanatically pursuing has received yet another nail in its coffin. With dire warnings about the end of preventative care and an endorsement of crisis management, older people will be forced into hospital before they stand a chance of getting one of the scarce care beds that are left.
"Until the Department of Health listens to those who work within the health and social care system, more older people will be treated like an unwanted package in a macabre game of pass the parcel. It is time the Delayed Discharge Bill is scrapped and long term investment in our creaking care system is put in so that our elderly can be treated with dignity and not discrimination."
Ends
The NAO report 'Ensuring the effective discharge of older patients from NHS acute hospitals' is released on the 12th February 2003
Page 33 warns of the consequences of the proposed fines system that is due to be discussed in the House of Lords on the 17th and 18th February. It said:-
"3.22 However, on the basis of concerns raised by numerous bodies that we spoke to in England, the department should be alert to possible undesirable outcomes such as:
• Perpetuating historical funding imbalances between the acute and social care sectors, and reducing funds available for the commissioning of older people's services;
• Creating perverse incentives for social services departments to place people in the most readily available, rather than the most appropriate, type of care;
• Causing patients in acute care to be prioritised over those in non-acute;
• And penalising good-quality social services departments for situations beyond their control."
Table 22 on Page 36 shows that for the first time, demand is exceeding the recommended bed occupancy rate of 90% for residential and nursing home supply across 6 out of 9 areas (North West, West Midlands, Eastern, London and the South East) and over the whole of England. This is agreed to be the 'gridlock' point for the care sector. In London, the South East and the West Midlands demand exceeds supply leading to either more bed blocking, long waiting lists for care homes, or older people being discharged into inappropriate settings. In effect, the system has collapsed.
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