Healthcare chiefs have received an £11.5million government boost to try to crack a hospital bed-blocking winter crisis in the Bristol region. The cash, split between the new local health authority Bristol, North Somerset and South Gloucestershire (BNSSG) Integrated Care Board (ICB) and the three local councils, is from a £500million Department of Health and Social Care emergency pot to get medically fit patients out of hospital.
Bosses are now deciding how best to use the money, which is aimed at easing pressure on hospital wards clogged up with too many patients who are well enough to leave, but cannot be discharged because there is often no place available for them to be looked after in the community. The “adult social care discharge fund” should speed up the process of getting people into the most appropriate setting, as well as relieving the knock-on effects of packed A&Es and long ambulance queues.
It can be used to pay for more adult social care staff during the current crisis and other ways of freeing up hospital beds, such as homecare and a programme called “discharge to assess” where patients continue to have their care and assessment out of hospital. BNSSG ICB chief executive Shane Devlin told a meeting of the board that many of its longer-term priorities had been suspended until April, with all focus now on getting as many people out of hospital safely when they have ‘no criteria to reside’ – also known as bed-blocking.
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He said: “The major objective in winter is about keeping people safe, particularly with regard to ‘no criteria to reside’. No matter which way we cut this, the most important thing for winter is can we get ‘flow’ and can we assure ourselves that people who don’t need to be in hospital aren’t in hospital because we know that causes a massive amount of harm, not only to people in bed, both cognitively and physically, but also in flow with regard to ambulances.”
Mr Devlin told the meeting on Thursday, December 1, that BNSSG had received a “very high proportion” of the £500million emergency funding “given the challenge that we face”. He said: “I want to re-emphasise the importance of winter – we are all over it, that’s what we have to do this year.
“If we are to get on with our strategic aims – our population health, health improvement, value for money and social and economic change – we have to deliver winter this year because if we don’t, we will never get the airspace to get onto the other things that really make a huge difference to our population.
“The focus is on making systems and processes work better to make the job of the individual in the ward or the care worker actually manageable. Having had the pleasure of working in hospitals for many years, the worst thing is when you’re doing lots of work but you’re doing it with patients who shouldn’t be there, they need to be somewhere else.
“Therefore the aim of this is to make sure patients don’t end up in the wrong place but it has to focus on making a productive workplace, and at the moment our workplaces are not as productive as they can be because we have an inability to get people to the right place of care. The risk isn’t that we won’t have the systems in place but there is a massive cultural shift we are trying to do in a very short time.
“If we are to get patients from a hospital to a community environment, we have to build trust – trust in the clinicians in the hospital that our systems are good, trust in the community that will be receiving patients. Our biggest risk is we’re trying to do this at speed, when we do not have a longer period of building trust between organisations and between clinicians.
“It’s very clear that is the challenge we have – can we build the trust, that the professionals can say ‘Mrs Smith can go home today because I know someone is going to catch Mrs Smith in the community’, whereas if you don’t have that trust you would say ‘I’m going to keep Mrs Smith in for another day’?” A report to the board said the ICB had been allocated £8.3million, Bristol City Council £1.7million, South Gloucestershire Council £780,000 and North Somerset Council £770,000 for its social care departments, with all money pooled.
A letter from Social Care Minister Helen Whately announcing the funding said: “Delays to discharging people from hospital when they are fit to leave continue to be a significant issue. “Not only does this mean fewer hospital beds available for those who need them; it also means people who would be better off recovering at home or in residential care are instead spending too long in hospital.”
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