National disability insurance scheme participants are spending months longer than needed in hospital as they await funding packages from the agency that runs the scheme, a new report shows.
The report, from the Summer Foundation and La Trobe University, suggested that, while for many people this period was between one and three months, there was “substantial variation with some people spending months (up to two years) unnecessarily in hospital”.
Overall, government data showed there were 1,140 participants stuck in hospital waiting for housing funding or other support before they can be released.
And the Summer Foundation said more than 50 young people with disability were moved into aged care each month because they were waiting for NDIS funding for appropriate housing.
The new report used hospital data looking at the files of 368 people to determine the number of “unnecessary bed days” they had experienced, as well the primary reason they were unable to be discharged.
While there has been an improvement in the data since 2016, the report still found the median number of “unnecessary bed days” in 2020 was 65, or more than two months. That was essentially steady from 2019, but down from 93 days in 2016. No more current data was available.
The report calculated the number of “unnecessary bed days” by looking at the date the patient was clinically ready for discharge, compared to when they actually left hospital.
Leila Boahene, 63, suffered a stroke in April last year and now uses a wheelchair to get around.
Her sister Helen Milovanovic said the whole process of acquiring an NDIS package for Boahene while she was in hospital had been a nightmare.
The NDIS plan did not come through until December, with Boahene stuck in hospital and then a rehabilitation centre for many months, despite the fact she could have otherwise been discharged without the appropriate support in the middle of last year.
“Mid April to December is the time it took to prepare an application, get all of the necessary evaluations, send it off to the NDIS, repackage [the application], resubmit and get a decision,” Milovanovic said.
Milovanovic said the family lodged its initial NDIS application in July but it had been initially been rejected. This meant had needed to provide additional information, prolonging the process.
Despite now having funding for supported disability accommodation, Boahene had been unable to secure suitable disability accommodation, meaning she was currently stuck in an aged care facility.
Boahene said the staff at the hospital and rehab centre had been great, but the delays were “long and painful” and the environment had been grim.
“I’m hoping to be more independent, which I am going to be,” she said. “The doctors said I won’t walk again. But I’m going to prove them wrong.”
The Summer Foundation and La Trobe University report found more than a third (34.5%) of all patients in the study experienced a delay to being discharged.
It said the most common reasons for discharge delays were NDIS planning-related delays (33%), sourcing a suitable discharge destination (25%), and arranging support on discharge (16%).
The report recommended that hospitals implement “early alert systems for people who are either NDIS participants or likely to be eligible for the NDIS”.
But it noted that “irrespective of how efficiently hospitals manage discharge planning, people will continue to face lengthy delays and discharge to aged care if funding decisions are not made quickly and appropriately”.
“Funding should be provided quickly and flexibly to support the timely discharge back into the community rather than taking many months, leaving people with disability spending unnecessary time in hospital which, aside from the social costs, places pressure on already stretched health systems,” the report said.
State governments have argued that delays to the discharge of hospital patients due to issues with the aged care and NDIS system are placing further strain on state health systems.
The report also found that 71% of participants in a separate survey had experienced difficulties in securing housing for NDIS participants once their funding package was approved.
In her sister’s case, Milovanovic said she’d been in touch with a number of housing providers, but had found the process slow and confusing.
The family believed it had now found an appropriate home for Boahene, but the process could take another six to eight weeks before she was able to move into her own home.
Her son, AJ, agreed the process of obtaining an NDIS package and then suitable disability accommodation had been frustrating.
“It feels like one step forward, five steps back,” he said. “It’s been like that for nearly 12 months. We just want it to end, and get mum settled, so she can get on the rest of her life.”
An NDIA spokesperson said “ensuring the safe and timely discharge of NDIS participants who are medically ready is a priority for the NDIA”.
“However it’s important to note the drivers of hospital discharge delay are complex and may involve a range of issues outside of the NDIS. The NDIA and state and territory governments are each responsible for certain policy and operational solutions,” the spokesperson said.
“For example, NDIS participants awaiting discharge may need access to a range of state government delivered services, including rehabilitation, housing and homelessness services, transport, mental health and justice support.”
The spokesperson said the agency had a range of initiative to improve the hospital discharge process.
