Health Secretary orders hospitals to tackle bed-blocking scandal

The Health Secretary has ordered hospitals to tackle weekend bed-blocking as he hinted the NHS is in line for more cash in today’s Budget.

Steve Barclay said bosses are failing to discharge enough medically fit patients on Saturdays and Sundays, when staffing levels are typically lower.

He told the NHS Providers conference in Liverpool that a £500million discharge fund announced in September will be distributed from the start of next month.

The money will be used to get more patients out of hospital by paying for extra physiotherapy sessions or hiring carers to help them cook and wash in their own home.

NHS England figures show there were an average of 10,211 discharges a day on weekdays in the four weeks from October 3 to October 30.

But there were only 6,828 a day at weekends — 33 per cent fewer.

It comes after the country’s leading A&E doctor warned that hospitals are so full it is harming elderly patients.

Dr Adrian Boyle said he was desperate to keep his parents out of hospital this winter because he fears they will not come out again.

The bed blockers are hampering the ability of ambulances to offload patients and respond promptly to 999 calls and slowing the rate at which hospitals can tackle record waiting lists.

The NHS’s bedblocking crisis has exploded since the pandemic with the levels of delayed discharge around triple the comparable figures before the pandemic. Graph shows: The number of beds occupied by patients that are medically fit for discharge over time

Some of the trusts with the biggest bedblocking problem, like North Bristol had almost one in three beds taken up by patients which were medically fit to be discharged

Mr Barclay told the conference that delayed discharges from hospitals must be tackled and highlighted the lower weekend rates.

‘Sometimes one can see in hospitals at the weekend that discharge drops so the question then is what is within the trust’s own control?’ he said.

‘Obviously, consultants at the weekend, what they can do? Often you get specific issues: palliative care, dementia, Parkinson’s. There is often a range of factors.’

His comment comes after a doctor said last week that NHS hospitals are like the Mary Celeste — an empty and abandoned ship — on Friday afternoons.

Dr Andrew Stein, a consultant kidney specialist who runs a guide for patients on how the NHS works, said underuse of facilities at weekends was hampering efforts to tackle the growing NHS waiting list.

Claire Murdoch, the national NHS England director for mental health, told the conference: ‘I’ve been a bit shocked to hear that … quite often ward managers are Monday to Friday people. 

‘I think we do need our most senior folk across the seven-day period.’

Discussing the adult social care discharge fund, Mr Barclay said: ‘In line with our devolved and data-driven approach, we will allow local areas to determine how we can speed up discharge of patients out of hospital.

‘This might be through purchasing supportive technology, through boosting domiciliary care capacity, or funding physiotherapists or occupational therapists to support recovery at home.’

Mr Barclay denied reports published in The Times that he had suggested the NHS did not need any more money to meet inflationary pressure on costs.

‘That is completely incorrect,’ he said. ‘The good thing about this is colleagues in the room will be able to see tomorrow.

‘I can assure you that the Treasury wouldn’t allocate any money to the department if the department said it didn’t need it, given the fiscal situation we face.

‘So in short, of course, we face significant financial pressures and inflation is there.’

He urged delegates to judge him on the results of Thursday’s announcement, saying they should see whether ‘it is true or not that we don’t get a penny and I’ve not asked for a penny’.

NHS England has warned it is facing a £7billion hole in its finances next year.

The NHS is set to receive £152billion in 2022/23, £157billion the following year and £162billion in 2024/25.

Official figures show 7.1million people in England were in the queue for routine hospital treatment, such as hip and knee operations, by the end of September — the equivalent of one in eight people (red line). The figure includes more than 400,000 people who have been waiting, often in pain, for over one year (yellow bars)

NHS England data show just over 275,000 inpatients were given an operation or were treated in hospitals in August this year. It was down 6 per cent on the 293,000 average treated in the three months up to August in 2019

HM Treasury data shows the NHS received £100.4billion in 2010/11 and its core budget has grown steadily until 2019. In 2020, the NHS was given £129.7billion of core funding for its usual services, which was topped up with an extra £18billion to help with the pressures from the pandemic. For 2021/22 the Treasury said the health service received £136.1billion pounds of core funding, as well as £3billion to help with the Covid recovery. The health service has been allocated £151.8billion for 2022/23

Meanwhile, emergency care performance has deteriorated to fresh lows. More than 1,400 A&E attendees were forced to wait in more than 12 hours for care every day in October (yellow bars), while the lowest proportion ever recorded were seen within four hours — the NHS target (red line)

Ambulance performance statistics for October show paramedics took longer to arrive to category one, two and three call outs since records began in 2017. Ambulances took an average of 1 hour, one minute and 19 seconds to respond to category two calls (red bars), such as burns, epilepsy and strokes. This is more than three times as long as the 18 minute target

Cancer care plummeted in September. Just 60.5 per cent of patients started cancer treatment within two months of being referred for chemotherapy or radiotherapy (red line). The figure is down from 61.9 per cent one month earlier and is the lowest ever recorded in records going back to October 2009. The NHS states 85 patients should start treatment within this timeframe

Saffron Cordery, chief executive of NHS Providers, which represents NHS trusts, said: ‘Trust leaders will welcome reassurances from the health and social care secretary that he has been batting on the NHS’ behalf in negotiations with the chancellor ahead of tomorrow’s fiscal statement.

‘They will also be pleased that he has recognised the critical importance of capital investment in the NHS and confirmation that the £500m discharge fund previously trailed by government will be released shortly.

‘Inflationary pressures have left a £7bn shortfall in the NHS’ budgets and tough efficiency targets mean more savings will be hard to find without impacting on frontline patient care.

‘Leaders across the NHS will scrutinise tomorrow’s fiscal statement to see if the chancellor has heeded warnings from trusts — and the health secretary — about the urgent need to tackle the financial and workforce challenges facing the health service.’