NHS spends £4m a week on elderly who block beds with managers blaming cuts for problems getting worse
The NHS is being forced to spend nearly £4million a week keeping elderly patients in hospital who are well enough to go home, according to a report.
More than nine in ten health service managers fear that the problem of so-called bed-blocking is getting worse following financial cuts.
The figures relate to patients – the majority of whom are elderly – who have to remain in hospital even though doctors have declared them medically fit to be discharged because their local council has not set up the necessary help for them at home.
It may be that they have suffered a stroke or have severe dementia and need to be moved into residential care homes.
Others will need their council to arrange extra home help from a carer or have a stair-lift or extra railings installed.
But delays are occurring because many councils are unable to pay for the help immediately as their budgets have been slashed.
This is leading to thousands of elderly patients being effectively trapped on NHS wards. Figures from the Department of Health show that these patients spent 76,000 days a month in hospital unnecessarily last year.
This is up nearly 10 per cent on the previous year with just over 69,000 lost days. Just over 28,300 patients were kept in hospital unnecessarily last year, slightly down on the previous 12 months.
It costs the NHS an average of £255 to keep a patient in a hospital bed overnight.
The report by the NHS Confederation – which represents all organisations in the Health Service – estimates that the phenomenon is costing £545,000 a day – just under £200million a year.
This is more than the Health Service spends treating either skin cancer, lung cancer or patients who have suffered serious burns. And 92 per cent of hospital chief executives, chairmen and other senior managers believe the problem has worsened in the last 12 months, according to the organisation.
Its report warns that the phenomenon has a ‘financial and human cost’ and that council funding for care is not keeping pace with demand.
Increasing numbers of older people are relying on funding, yet at the same time, local authorities are having their budgets slashed.
Jo Webber of the NHS Confederation said: ‘The Health Service cannot keep on picking up the pieces of a broken social care system.’
Michelle Mitchell, charity director at Age UK, called for the Government to show ‘vision and courage’ to tackle the problem.
‘The social care system has been under-funded for years, failing to keep pace with the rising demand of an ageing population,’ she said.
‘The Government needs to show vision and courage and put in place the fair and sustainable funding that’s required to ensure older people both now and in the future get the care they desperately need.’
‘The social care system has been under-funded for years, failing to keep pace with the rising demand of an ageing population.’
David Rogers, chairman of the Local Government Association’s Community Wellbeing Board, said: ‘As resources become increasingly stretched, closer and more effective working between councils and the NHS will be an essential part of how we look after our ageing population.
‘However, there is unquestionably an immediate and growing funding crisis in adult social care which needs to be urgently addressed, alongside wider reform to the system to make it simpler and fairer.’
A Department of Health spokesman said: ‘We are already providing £7.2billion over four years so that local authorities have sufficient funds to protect people’s access to care and support.’
Earlier this year a separate report by the NHS Confederation urged medical staff to stop describing such patients as ‘bed-blockers’, saying this is a derogatory term.
The NHS’s official description for bed-blocking is a ‘delayed transfer of care’.
Secret report reveals lives will be at risk in sweeping plans to close 25 NHS casualty units
Sweeping plans to close casualty departments carry a ‘code red’ risk of having a serious impact on patients’ health, a secret internal NHS study has revealed.
The shocking disclosure comes in a risk-assessment dossier, prepared by officials pushing for the closure of four out of nine A&E units in North-West London and obtained by The Mail on Sunday.
It comes as our campaign against the cuts gathers pace, and as:
* The number of units which have already been closed or downgraded, or are facing such cuts reached 25.
* Almost 7,000 Mail on Sunday readers signed our petition to persuade Health Secretary Jeremy Hunt to curb the shutdowns.
* More heartbreaking stories emerged from areas where A&Es have already closed – including the case of a retired ambulanceman who died from a heart attack having taken over an hour to get to hospital.
Asked whether he would order a review of the closures in light of public opposition, Mr Hunt restated the policy of his predecessor, Andrew Lansley, that changes must be ‘locally led’ by health professionals, and that ‘the interests of the local community must be key’. Critics say that, in fact, many doctors oppose the cuts, as does the public.
Where A&E units are facing closure, NHS bosses have insisted that they have only one aim – improving patient care – and not saving money.
For example, in adverts designed to persuade sceptical residents of the benefits of radical closures in North-West London, NHS bosses say it is a ‘myth’ that the cuts have been drawn up in order to save money.
Yet the secret report from the ‘cluster board’ responsible for commissioning health care for the two million people in the area clearly states that one objective is to deliver £1 billion of savings by 2014.
The ads also state that it is a ‘myth’, that the changes will put patients’ lives at risk. Yet the internal report, discussed at a closed meeting on September 7, identifies a ‘significant’ risk of adverse effects. Its most damning section concerns a ‘new risk’ to ‘Objective One’, the reorganisation itself.
The risks are that the closure plans are ‘not accepted by patients, politicians and public’, that the care provided by GPs is ‘not robust enough’ to support the enormous extra burdens the closures will impose, and that the ‘new pathways of care’ will therefore not be successful.
The consequences – graded ‘code red’ for being ‘significant’ and ‘serious’ – would, the dossier admits, be ‘poor patient experience and outcomes’, ‘service gaps’, and the whole system becoming ‘unaffordable’.
Last night a spokesman for the NHS in North-West London insisted that the risks would only apply if planned improvements to ‘out-of-hospital’ GP care did not go ahead.
He said: ‘We have said very clearly, in public meetings and in all our documents, that no changes would be made to any hospitals before we had first spent three years implementing the out-of-hospital changes.’
As to the £1 billion savings target, he said the NHS had never hidden its hopes to save money, but insisted that was not the main aim.
The spokesman’s statements drew a furious response from Labour MP Andy Slaughter, whose Hammersmith constituency includes two of the doomed A&Es, Hammersmith and Charing Cross. Ealing and Central Middlesex are the others. ‘It’s all very well saying no department will close for three years, but the decision will be announced in 2013,’ he said. ‘Once you’ve done that, how will the A&Es attract staff? They’re likely very quickly to wither away.’
Meanwhile, The Mail on Sunday today reveals another 11 areas where millions of patients could face longer journeys for A&E.
In Hertfordshire, A&Es at Hemel Hempstead and St Albans have already been replaced by downgraded units, while Welwyn Garden City’s A&E will close next year.
In Burnley, Lancashire, there is a growing campaign to reinstate the A&E ward closed four years ago.
And the A&E at either Redditch or Worcester in the West Midlands will be closed, with no decision on which made yet. Nearby Kidderminster Hospital already only has a minor injuries unit after its A&E was closed down, but it could now lose this too.
NHS chiefs say: ‘This change is being led by clinicians, who have said that doing nothing about the A&E situation is not an option. The proposed changes will improve patient safety and quality of service.’
Acute medical services at Neath Port Talbot hospital in South Wales were moved to Swansea and Bridgend last month. Although not strictly an A&E department, the unit could have treated heart attacks and strokes.
Three other hospitals stand to lose the ability to treat major trauma cases such as car accidents, effectively downgrading the departments.
The policy is designed to centralise specialist services, but many critics fear it is risking lives. Retired nurse Patricia Wright, 65, used to work at Princess Royal Hospital in Haywards Heath, which lost its capacity to deal with trauma cases four years ago.
She said: ‘Ambulance staff have told me that some patients didn’t make it as they had to be taken the 15 miles to Brighton.’
Teachers must go the extra mile if they want a payrise, British regulator says
Teachers should “go the extra mile” and work longer hours if they want to be granted a pay rise, the head of Ofsted Sir Michael Wilshaw has said.
Sir Michael said inspectors will now mark down schools that increase the pay of teachers who persist in being “out the gate at 3 o’clock”.
The chief inspector of schools for England said he expected teachers to “go the extra mile” for children, including staying on beyond the end of the school day.
They should be particularly willing to help pupils in poor areas, he suggested, with head teachers and governors now obliged to justify staff pay rises.
Sir Michael, head of Ofsted, told the Times newspaper “something is wrong” with pay rises being awarded to more experienced teachers regardless of their performance.
He said: “”In last year’s (annual) report, we said that 40% of lessons overall were not good enough. And yet everyone is getting a pay rise. Hey! Something is wrong with the system.
“As a head I would make it clear that if you teach well or try to teach well, if you work hard and go the extra mile, you are going to get paid well.
“You are going to be promoted. Somebody who is out the gate at 3 o’clock in the afternoon is not. Isn’t that fair? Am I being unfair?”
He also said teachers who are unwilling to act as surrogate parents to pupils in poor areas who lacked support at home did not deserve a salary increase.
“It’s about recognising those people who do go the extra mile,” he said.
His comments have already been met by criticism by teachers’ leaders, who have accused him of appearing to be “at war with teachers in this country”.
Kevin Courtney, deputy general secretary of the National Union of Teachers, told the newspaper: “This adds to the impression that Sir Michael Wilshaw wants to be at war with teachers in this country. “We don’t want a system where head teachers pick and choose favourites for pay rises.”
Chris Keates, general secretary of the Nasuwt, said: “Teachers are in the second year of a public sector pay freeze and evidence shows that teachers who have earned pay progression are being denied it. It ill behoves the chief inspector to allow his role to be reduced to being the mouthpiece for the myths and misinformation peddled by the Secretary of State.”
British badger militants put pictures of Minister’s home on the net in ‘campaign of intimidation’ over controversial cull
THE Environment Secretary has been targeted by animal rights militants who have published photos of his home online as part of a campaign of ‘intimidation’ against a controversial badger cull.
Owen Paterson – who last week approved the cull in Gloucestershire to try to stop the spread of TB among cattle – was forced to obtain a High Court injunction against the website, which also lists his address and office phone number.
Although activists removed the information, within hours it had reappeared on a ‘mirror’ site hosted in Australia but easily accessible in the UK through a simple Google search.
The website claims a high-level Civil Service mole, sympathetic to their cause, went ‘out on a limb’ to leak the private details.
It has also published addresses and phone numbers for senior Defra civil servants, board members of Natural England, which is licensing the cull, and officials at the National Farmers Union.
The Mail on Sunday is not revealing details of the website to protect those named. We have also established the identity of the British woman behind it but for legal reasons – linked to an unrelated police investigation – she cannot be named.
The site, which advises protesters to ‘stay legal’, carries photographs of Mr Paterson’s North Shropshire home under the headline ‘House on the hill. Owen Paterson has a posh place’. There is also an aerial shot and a view of the main entrance gates – key information for any extremist planning to trespass.
It will also concern police given Mr Paterson’s previous role as Secretary of State for Northern Ireland, where he was an obvious target for terrorist groups.
Text on the anti-cull website boasts Mr Paterson is ‘very, very angry about the site publishing his office phone number. Many people are ringing it and playing the “badger badger” song to him’. This is a reference to a YouTube video in which cartoon badgers dance to a soundtrack.
The website adds: ‘Below is the rest of the ministers [sic], this was leaked to us by someone who is high up in the civil service. Please put a few minutes to one side each day to contact them.’
Martin Haworth, director of policy at the National Farmers Union, said: ‘We are very disappointed this has happened. We have asked Defra and Natural England how this information could have been discovered.’
Natural England declined to comment on the leak ‘for security reasons’.
A Defra spokesman said last night that its databases had not been compromised.
Police are preparing for fast-track prosecutions against activists who launch night protests against the badger cull.
Farmers taking part have been asked to sign a police witness statement known as an MG11, saying they have not given permission for anyone to disrupt the cull.
By collecting the forms in advance, police hope they can bring about charges more quickly.