After a stay in hospital, most people can't wait to get back to the comfort and familiarity of their own home. But for a growing number of people that isn't an option, either because their homes are unsuitable or there is inadequate care in the community to provide the support they need.
Latest figures from NHS England show there were nearly 185,000 days of delay in discharging patients from hospital in July this year – up by a quarter on the same month last year.
Sometimes called 'bed blocking', these delays in discharge mean vulnerable patients remain stuck on hospital wards until arrangements can be made for them to be safely discharged, either to their own home or another appropriate place.
There are two key consequences for the NHS. The first is cost, with a report last May by the National Audit Office suggesting that delays in discharging were costing NHS England £820 million per year. BY contrast, the cost of caring for such patients in the community would be around £180 million.
The second consequence is that the NHS continues to miss its key waiting time goals. In other words, the length of time patients wait to go into hospital for a procedure is longer because there is a shortage of available beds, due in large part to delays in discharging other patients.
Waiting time targets for cancer care and routine operations are being missed, while the discharge delays also have a knock-on effect for other hospital departments such as Accident and Emergency (A&E). Hospital staff are also hampered in their efforts to improve care for patients who need to be in hospital because so much time and effort is devoted to those who needn't be there if there was a safe alternative.
In the past, 'bed blocking' has been a particular problem for the NHS during the winter months, with the summer traditionally providing a respite. The latest figures show this is no longer the case.
Nigel Edwards, chief executive independent Health think-tank The Nuffield Trust, commented: "Today’s statistics, covering July, show that the days of a traditional summer respite for the NHS are gone for good. The figure for delays in discharging patients from hospital is particularly worrying – up by a quarter in just 12 months.
"What’s more, I am very concerned that these official figures systematically understate the true scale of the problem – I think NHS England and the Department of Health should look more rigorously at the way they calculate these delays. The NHS stands no chance of transforming the way care is delivered to patients while it is still struggling with this problem."
Staying too long in hospital can also be counterproductive for patients. When the National Audit Office (NAO) issued its report in May it quoted research showing that for every day spent in hospital an older patient can lose 5% of their muscle strength. There is also the increased risk of infection.
The NAO report said official figures showed the number of delays in discharge had risen by a third in the past two years, to 1.15 million days per year. But it also claimed the way the figures were recorded meant they were likely to be significantly understated, with a "truer figure" likely to be nearer 2.7 million days of delay.
Head of the NAO Amyas Morse said: "There are currently far too many older people in hospitals who do not need to be there. Without radical action, this problem will worsen and add further strain to the financial sustainability of the NHS and local government."
Given the UK's ageing population, the situation is likely to get worse unless remedial action is taken. More nursing home places – as a 'halfway house' option during recovery – and more investment in providing care and support for people in their own homes are two main methods of reducing delays in discharge from hospital.
Another way is to adapt a patient's home environment to make it suitable for when they return from hospital. For many people this could mean installing a stairlift so that they can move easily between upstairs and downstairs without exertion or danger.
Acorn Stairlifts has made its name on being able to install high quality stairlifts at short notice, even on curved staircases which would traditionally need a two to three-week wait while a one-off rail is designed, manufactured and shipped. Instead Acorn's innovative FastTrack® system means a custom-built curved stair rail can be assembled in a customer's home in just a few hours.
Acorn company secretary Dave Belmont said: "A significant proportion of our customers find they need a stairlift in a hurry, perhaps after an accident or a stay in hospital. Our unrivalled response rate means we can install one of our award-winning stairlifts within just a few days, even next day if required.
"Having a safe and struggle-free way of getting up and down stairs could mean the difference between having to linger in a hospital bed longer than necessary or being able to return home to recover."