EXCLUSIVE RESEARCH: How much NHS bed blocking is down to community equipment delays?

Hospital patients waiting for community equipment or for their homes to be adapted caused nearly 45,000 days’ worth of bed blocking in the 12 months to November 2018, NHS England figures show.  

The equivalent of 123 beds per month across NHS trusts in England was blocked because patients had to wait for community equipment and adaptations during the period, AMP can reveal.

With a total of more than 1.5m days’ worth of delayed transfers of care (DTOCs) over the period, however, the wait for community equipment and adaptations caused just 3% of all delays in NHS England trusts between November 2017 and November 2018.

Other factors, such as patients awaiting further care or nursing home spaces, accounted for a much larger proportion of DTOCs across most local authorities.

The figures cover DTOCs attributable to both the NHS and social services. In November 2018, 62% of all delays were attributable to the NHS while 30% were attributable to social care, which includes community equipment waits.

The proportion of delays attributable to social care has decreased by 30% in the last 12 months. The NHS has also seen a reduction in the volume of DTOCs in the last year.

A delayed transfer of care – or bed blocking – occurs when a patient is ready to leave a hospital but is still occupying a bed. Both the NHS and social care sectors have seen reductions in the volume of delayed transfers of care in the last year.

Delays can have a severe impact on elderly patients. The NHS claims for a person aged over 80, a hospital stay of more than 10 days can lead to 10 years of muscle ageing.

Delays can occur when patients are being discharged home or to another facility but are held back if equipment or adaptations are not available for them in time.

NHS England collects data each month on the number of DTOCs across trusts. An average of4,416 days’ worth of delays occurred each month in 2018, although data for December is not yet available.

The NHS’s 10-year plan, unveiled earlier this month, promised to support ageing and increasing independence by ensuring people have more control over their care and support.

The plan proposed supporting people to age well by bringing different health and care teams together to make sure older people are getting the support they need to remain independent, avoiding unnecessary hospital admissions and tackling bed blocking.

Although critics have argued proposals for a £20bn investment are unsustainable, the government’s cash injection is designed to “transform patient care” and target a number of areas designed to reduce the number of people being admitted to a hospital, thereby easing pressure on NHS beds.

According to NHS England figures, DTOC numbers varied across local authorities. Recently, the health service pledged to tackle ‘health inequalities’ around the country by increasing funding for clinical commissioning groups (CCGs) in some of the most deprived areas.

Funding allocations for 2019-20 show that some CCGs will see a 15% increase in cash next year if the draft allocation is approved.

The NHS is following new formulas and making adjustments to allocations to “take account of health inequalities and unmet need” and grant worse-off areas with a larger proportion of the money available.

NHS England has been approached for comment.