Committee of Public Accounts

Press Notice No. 33 of Session 2002-03, dated 17 September 2003


Mr Edward Leigh MP, Chairman of the Committee of Public Accounts, said today that there is still an intolerable number of older people waiting too long to be discharged from NHS acute hospitals, and urged providers to work together better to plan the provision of care.

Mr Leigh was speaking as the Committee published its 33rd Report of this Session, which examined the action taken by the Department and the National Health Service, on their own and with local authorities and the private sector, to tackle the problem of delayed discharges of older patients from NHS acute hospitals. On any given day, some 3,500 older patients remain in National Health Service (NHS) acute hospitals after medical staff have declared them fit and safe to be discharged, because arrangements are not complete for them to move on. These delays cost the National Health Service an estimated £170 million a year and account for 1.7 million lost bed days annually.

The Committee found that the Department and the NHS have reduced levels of delayed discharge significantly since 1997, but some acute hospitals are still not implementing best practice for discharging patients, and there are still too many older people waiting longer in hospital than is necessary, including many for a month or more. The Government aims to end widespread delayed discharge by 2004, and is committed to reducing levels to around 3,000 by the end of 2004, and between 2,000-2,500 by the end of 2005. The Department does not expect that further reductions will be possible due to inherent delays in the system, but should review this assumption once the new cross-charging system has bedded in. 

Involving patients and their relatives and carers in discharge decisions is crucial for timely and appropriate discharge and is expected under the NHS Plan and the Health and Social Care Act 2001. Although almost all acute trusts consider they do involve patients, relatives and carers, many of these people do not see it that way. All Trusts should ensure that their current practices meet reasonable expectations, with discussions including full information on options available and the provision of a discharge plan. This may require them to survey patients to confirm satisfaction levels.

A long term solution to delayed discharges will only be achieved through private and public sector partners working together. The Department aims to expand capacity in a variety of care provision. In developing and reviewing local delivery plans, Strategic Health Authorities and Primary Care Trusts need to have a clear picture of current provision across health and social care in their local areas, consulting with independent sector providers when planning provision. In particular, they need to tackle the significant regional variations in the availability of intermediate care.

Mr Leigh said today:

"It is important that older people are discharged from NHS acute hospitals as soon as they are fit to leave, both for their own welfare and to avoid tying up hospital beds and resources that are already under pressure. The Department and the NHS have reduced delays since 1997, but it is intolerable that on any given day there are 3,500 older people waiting in hospital even though they are fit to be discharged. There is an urgent need for the Department, Health Authorities, Trusts and independent providers to work together better to plan care provision."

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