Headlines: July 30th, 2002

The Government has announced details of its plans to fine hospitals and local authorities which contribute to ‘bed-blocking’ – or – keeping older people in hospital longer than necessary because there is no suitable home care or care home for them to go to.The intention to introduce a ‘reimbursement’ scheme was announced in ‘Delivering the NHS Plan’ in April and is based on a system used in Scandinavia that has had a major impact on reducing delayed discharges.

The Government has waited until now to announce details of the possible penalties, as it says it has first been investing in support for new schemes which give local authorities the tools to tackle bed-blocking.

Initiatives to end bed blocking have already helped to reduce the number of people over 75 who are stuck in hospital. In March 2001 there were 5,938 delayed discharges and by the end of March this year there were 4,691.

A large proportion of the money has been used by Local Authorities to increase fees paid to care homes and in some areas the increase has been as much as 10%.

Last week Health Secretary Alan Milburn announced more social services investment for intensive home care packages, extra care housing, community equipment, services for carers, and intermediate care.

What the reimbursement system does is to clarify who is responsible for which stages of care, so that partners can work together on a smooth transition. It will give all partners a financial incentive to move patients on time. If a patient is moved out of hospital too soon and has to be re-admitted, the hospital could be penalised. If kept in hospital too long, then the local authority loses.

Full details on the proposals, which require legislation, are at www.doh.gov.uk/jointunit/delayeddischarge/consult.htm   and consultation will run until 18 September 2002.