As the crises in hospitals escalate, blame culture is rife. Whether it is older people living too long, migrants and ‘health tourists’ – all are in the firing line. The implication is that the more ‘deserving’ are not getting the NHS treatment that they require because ‘less of deserving’ people blocking their way.
More balanced views are out there. The major funding reductions in social care are increasingly being recognised as one reason why many older people are in hospital for longer than is clinically necessary.
The recent National Audit Office report, Discharging older patients from hospital, concludes that current official data significantly underestimate the scale of the problem, and that …‘health and social care systems’ management of discharging older patients from hospital does not represent value for money‘.
The search is on for solutions. Cue the rising interest in use of the extra funds for disabled facilities grants (DFG) paid into all local Better Care Funds (BCR) this year. One of the additional conditions attached to the BCF is to reduce delayed transfers of care. There are a few emerging beacons of innovation where fast track home adaptations and housing related services are being included in discharge processes, but they remain a small minority, with more preventative provision facing cut backs rather than increases.
Care & Repair England keeps on repeating its message about the housing, health & care links, encouraging the take up of fresh approaches and good practice, Last week saw the publication of our latest Integration Briefing 3 supported by Public Health England. This week our event, ‘Health at Home – The Right Prescription’ takes place in Manchester, shining a spotlight on the ways in which integrated housing interventions can reduce delayed discharge and increasing independence at home for older people. Yet we do also recognise the massive challenges that those trying to balance the books face, challenged on all sides to do more for less and less.
Nevertheless, without more visionary planning and commissioning of preventative services that fundamentally address the state of the homes and neighbourhoods that people live in as they get older, those queues in A&E are just going to keep on getting longer. [June 2016]