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Bed-blocking claim by NHS boss ‘a conservative estimate’

Emergency doctors warn of intolerable situation

Jo Carlowe

Wednesday, 08 June 2016

Claims by NHS England boss that bed-blocking delays look set to continue for “up to five years” is an underestimate, emergency doctors have said.

NHS Chief Executive Simon Stevens, this week, told MPs that the number of blocked beds may not clear anytime soon, due to social care pressures.

Mr Stevens made his comments to the Public Accounts Committee, during which both the Royal College of Nursing (RCN) and Royal College of Physicians (RCP) cited staffing problems as one of a “multitude of factors” that lead to delayed patient discharge, and Age UK highlighted the “ongoing crisis in social care funding”.

But the Royal College of Emergency Medicine (RCEM) has described Mr Stevens’ prediction as, “a conservative estimate”. 

Dr Clifford Mann, president of the RCEM, said the current situation is “unacceptable”, and not “tolerable”. 

“People should be aware that this as an existential threat to the safe delivery of emergency care. The current crisis is the consequence of silo behaviours in a fragmented system. The College welcomes the recent report by the National Audit Office and the related comments by the Commons' Public Accounts Committee. It is unacceptable for anyone to regard the current situation as tolerable,” he said.

A recent report from the National Audit Office (NAO) found that for every 100 beds, three days of use were taken by patients who no longer needed to be hospitalised. The NAO estimated that bed blocking costs the NHS £820m a year, with 1.15m bed days lost to delayed transfers of care in 2015.

The RCEM estimates over 500,000 patients a year are affected by “Exit Block” (bed-blocking) the knock-on effects of this problem (which leads to longer waiting times in A&E), which in turn accounts for more than 500 deaths every year.

Dr Clifford Mann said: “Working in overcrowded departments, where care is constantly impaired as a consequence, saps morale and is a key cause of burnout and poor retention of staff. If this is not tackled, the increased pressure on staff will become too much to bear and will make recruiting to posts even harder than it is at present. This in turn will put patients at even greater risk.” 

The College also cites cuts to social care as exacerbating the problem, with more patients occupying beds for longer, simply because they now have nowhere to go for after-care. 

The Association of Directors of Adult Social Services in England (ADASS) recently reported that adult social care budgets had suffered 31% budget cuts in the last parliament. 

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