The queues of ambulances outside hospital A&E departments are a sharp and recurring reminder to the government that hospitals in England are at crises point. Sir Kier Starmer this weekend claimed that the NHS is no longer on its knees but is now on its face.
Senior NHS staff are now so concerned that they believe the delay in admitting patients into hospital is now causing more 500 deaths per week. Too many, this is astounding, given 12 years of Conservative government Ministers are only now recognising the seriousness of the situation.
Bed blocking
This has ben an issue for many years. It has been estimated that over 13000 beds are now occupied by patients in NHS Hospitals who could be supported by social care in the community. Thus, preventing admission of people who are in urgent need of medical attention.
These people have been trapped because of lack of investment in social care services. They want to leave but there are no places available for them in care homes or care packages that would provide appropriate domiciliary care. It can be seen then that not only is the NHS denying people choice, but it must also be costing more providing hospital accommodation than it would by providing care in the community.
How have we arrived at this situation?
The government have failed over many years to recognise the interrelationship between the NHS and social care. That is hospitals cannot function to their capacity without the ability to discharge people who no longer require medical treatment back into the community.
Despite numerous promises including that of Boris Johnston who said on the steps of Downing Street that he would fix the problem of social care, nothing ever happened. Even the present chancellor has put reform back to 2025.
Consequently, there has been no long-term planning and piecemeal investment that has done nothing to solve them.
Failure to pay care staff reasonable wages has led to a mass exodus of staff who care for people to the retail sector where they can earn far more money. Nor is just a problem of staff leaving the industry it is also a massive problem trying to recruit them. It is now estimated that there are over 160000 staff vacancies in the sector.
Care homes and domiciliary care agencies have returned contracts back to local authorities because they cannot recruit sufficient staff to fulfil them.
Proposed action by the Government
Faced with the crises in the NHS the government has been forced to take action to reduce the level of bed blocking and free up much needed beds for patients requiring medical treatment.
The short-term solution is a mix match. The block purchasing of care home beds, the use of hotels, accommodating of patients in portacabins and the creation of emergency wards are all aimed at releasing 2500 people from hospital.
This short-term fix opens up another set of problems. Research has shown that most people would prefer to live in their own homes rather than a care home. Many will not take too kindly to being denied a choice.
Summary
At last, the government has taken action on bed blocking and focusing more attention on the importance of social care to addressing the problem.
Ministers cannot say that they did not see the crises in the NHS coming. They have had plenty of warning. Medical advisors last year predicted a surge in the rates of Flu following the pandemic. The tipping point that has led to government action is the occupancy rate in hospitals that is nearing full capacity.
Time will tell if the short-term fix alleviates the problem, but it is difficult to defend the governments delay in taking action and we are no nearer a long-term solution.
Rishi Sunak claims that social care is now one of his top priorities. However, if we look back at the record of promises of action by his predecessors, perhaps it would be inadvisable to hold our breath. It is often said that the NHS is the sacred cow of British politics. Too many observers it is now in need of an urgent transplant.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy