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Nottingham

Council to use care home beds to free up hospital spaces for those well enough to leave

Patients are being placed in care home beds across Nottingham in a bid to free up hospital beds.

Over the past year, the number of people waiting to get social care support, particularly home care, has consistently surpassed 100 people every month in the city.

This is largely due to a lack of capacity in social care, leaving medically fit patients in much-needed hospital beds for longer than required.

Nottingham University Hospitals (NUH) NHS Trust, which runs the Queen’s Medical Centre and City Hospital, says the number of people waiting for discharge is ‘frequently’ 180 to 200 patients, well above the target of 64.

Nottingham care home beds are already being used on an interim basis to help free up hospitals.

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Through the use of these and a new ‘transfer of care hub’, which helps get people out of hospital and back into the community, Nottingham City Council has managed to get its social care waiting list down from 177 before October to 60 as of January 11.

But councillors fear the actions may simply be acting as a “sticking plaster” solution.

During a Nottingham City Council Health and Adult Social Care scrutiny meeting at Loxley House on Thursday, January 12, councillors were briefed on the situation amid the worsening crisis in the NHS and wider healthcare systems.

Sara Storey, the Director of Adult Social Care at the council, said: “Across the system in Nottingham, we are absolutely committed to the principles of home first.

“Because of the challenges and the risks in terms of home care and community-based capacity, which again are national challenges, we do know we have really struggled to find the sufficient capacity to get people home.”

Earlier in January, the Government announced it would be providing a portion of a £200m grant to local areas across the country to help with the purchasing of temporary beds in care homes.

Across the country, the number of patients in hospitals medically fit for discharge is estimated to be around 13,000.

Cllr Sam Webster (Lab) added he fears patients may end up becoming trapped in a care home instead.

He said: “You’d have thought most of those people would have moved from the hospital back into the home setting if the care services were provided at home?

“Everything we’ve been saying recently and everything the system says is about if you put people into residential care, there is a good chance they will never come back out of residential care, and there are huge ongoing costs for many years potentially after that.”

Responding, the Director of Adult Social Care for the council said: “We have, as a plan B in Nottingham, unfortunately, had to use those beds on an interim basis, but the focus was getting them back home as soon as possible.

“Not an ideal solution but something, unfortunately, we have had to do as that is still the less risky option than keeping people in hospital and causing further delays in terms of those ambulances struggling to hand over.”

It is understood a number of new jobs have been created, with the use of agency staff, however, pay and working conditions are hampering efforts to recruit.

Short-term funding allocations are also making it more difficult to recruit permanent staff members.

The staffing problems in home care and adult social care as a whole poses a “significant risk” in the city, councillors were told.

Background

Thousands of extra medically fit patients will be discharged from hospitals into community care settings, such as care homes, over the coming weeks to free up hospital beds and reduce pressure on the NHS, the Health and Social Care Secretary, Steve Barclay, is set to announce today (Monday 9 January 2023).

The government will make available up to £200 million of additional funding to immediately buy short-term care placements to allow people to be discharged safely from hospitals into the community where they will receive the care they need to recover before returning to their homes.

The move will free up hospital beds so people can be admitted more quickly from A&E to wards, reducing pressure on emergency departments and speeding up ambulance handovers. There are currently around 13,000 people occupying hospital beds in England who are fit to be discharged.

The additional £200 million – on top of the £500 million Adult Social Care Discharge Fund already announced which reached the frontline in December and is already helping discharge people more quickly – will fund maximum stays of up to 4 weeks per patient until the end of March. Integrated care boards – organisations that arrange health services in each local area – will begin booking beds that are most appropriate to patients’ needs.

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