Hundreds of patients staying in Bristol hospitals who are not sick enough to be there

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Hundreds of patients are staying in hospitals in Bristol who are not sick enough to be there due to severe delays. Once a decision has been made to discharge a patient from hospital, it can often take weeks before they actually leave.

In May, the number of patients staying in hospitals in Bristol, North Somerset and South Gloucestershire who didn't need to be there hovered around 350 and 400, NHS data shows. Patients staying longer than three weeks after a discharge decision was made stayed in total for about 3,500 extra days.

It’s unclear what the average wait is for each patient to go home after a discharge decision. But the average cost to stay in a hospital bed is about £550 a day, creating a massive and unnecessary cost to the NHS. Staying longer than needed in hospital also impacts the health of patients.

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Bristol City Council is planning to spend almost £4 million this year on freeing up blocked beds. Councillors on the adult social care policy committee on Monday, July 1, agreed to spend the discharge grant from the government.

The cash will go towards improving community reablement services and reducing the length of hospital stays and delays. Another area will be investing in social workers to assess what care and support patients need after leaving hospital.

Liberal Democrat Councillor Jos Clark said: “People are sitting in beds waiting to go home for far too long. In my experience a lot of the reasons that people are sitting in a bed for weeks — not days or hours — is that it’s the discharge-to-assess, it’s the home care, and it’s waiting on council staff which is stopping people from coming out of hospital.

“We all know that having somebody sitting in a bed for two or three days longer than they should, means that their ability to recover and bounce back is diminished greatly.”

One approach the council takes is known as “discharge-to-assess”. This means that some patients will be discharged from hospital first, and then be assessed what care and support is needed once they’re back at home. This frees up blocked beds in hospitals more quickly.

Recently the council has moved some of its staff back into Southmead Hospital and the Bristol Royal Infirmary. Social care staff can then start assessing what support a patient will need after they’re discharged, at the earliest chance.

Hugh Evans, executive director of adults and communities, said: “Some of the main reasons within [hospitals] that people end up staying are to do with simple things like take-home medications and awaiting for therapy assessments, and things like that. More often than not, over half the reasons are to do with systems within the hospitals themselves.

“It’s actually really relatively low amounts that are to do with things like waiting for social care packages. Which is why, as social services leads, we’re always a bit indignant when you get debates like on Channel Four the other day when they say it’s all to do with waiting for social care placements.

“Ideally, and both of our acute hospital providers say this, discharge should start at or just before the moment of admission, we should be working on that right from the outset on that. But actually the reality is, under significant pressure which varies throughout the week and at different times of the year, that doesn’t always happen.”

NHS figures show that in May there were a range of reasons across the integrated care board, which covers Bristol, North Somerset and South Gloucestershire, why people stayed in hospital longer than they needed to.

There were 56 patients who stayed in hospital longer than they needed to due to waiting for a bed to become available in a care home or nursing home that was likely to be a permanent placement. There were also 41 patients waiting for a bed in a community hospital or similar setting, and 38 waiting to be assessed for care at home.

There were four patients waiting for a therapy decision to discharge, 18 people waiting for a referral for care in the community and 65 people waiting confirmation that a referral had been received. There were just three people waiting on a medical decision, including writing a discharge summary, and nobody was waiting for medicines.