Increasingly, older patients are experiencing delays in being discharged from hospital. Such delays are bad for their health and increase the level of care they may need after leaving hospital. Unnecessary delays are also bad for the financial sustainability of the NHS and local government and the National Audit Office (NAO) has estimated a gross cost of around £800 million a year for the NHS of older patients delayed in hospital when they no longer benefit from being there. While it is clear there have been improvements and many in the NHS and local government are putting in significant efforts, the Department of Health (the Department) and NHS England rely too easily on differing local circumstances as a catch-all excuse for not securing improvement in performance. They should be doing more to increase the pace of integration and make local accountability systems more effective. Those areas which are doing best are the ones where all the local system owns all of the problem but this practice is all too rare.
The Department, NHS England and NHS Improvement have failed to address long-standing barriers to the health and social care sectors sharing information and taking up good practice. The result is unacceptable variation in local performance. While we recognise there are significant pressures on adult social care and NHS funding, NHS England shows a striking poverty of ambition in believing that holding delays to the current inflated level would be a satisfactory achievement. Patients and the NHS have a right to expect better.
19 July 2016