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Public Services for All > Published by Shamik Das, February 24th 2011 at 10:20 am

Another day, another false economy: The avoidable bed-blocking crisis

Following the revelation yesterday that more than 50,000 NHS jobs face the axe, a report out today shows how funding cuts are leading to an “intolerable” bed-blocking crisis. A report by Bupa, covered in this morning’s Telegraph and Mail, says the “chronic under-funding” of care homes, shortage of places and ageing population mean vulnerable people will have nowhere to go but hospital.

The Telegraph report adds:

“If current trends continue, almost 100,000 of 170,000 NHS beds will end up being filled by elderly people who are well enough to be in residential care.

“This will cost the health service millions of pounds and throw its day-to-day operations into chaos… [Bupa] blames the looming crisis on a ’17-year legacy of under-funding in the care home sector’.

“The next few years will see the problem getting progressively worse, the report’s authors predict, despite a Coalition pledge that local authorities will have an extra £2 billion to spend on adult social care over the next four years.”

As Left Foot Forward has previously reported, the cuts to council funding will only make the problem worse. In January, Age UK’s Hilary Evans wrote for us:

“We’ve been consistently arguing that one of the many unpleasant outcomes of failing to invest in good-quality social care for older people, both at home and in residential care settings, is that people end up staying in hospital unnecessarily.

“Being forced to stay in hospital longer than you have to has significant consequences for people’s wellbeing. Very few people would choose to stay in hospital longer than absolutely necessary, no matter how high the level of care. Extended hospital stays, particularly unnecessary ones, can be very distressing both for the patients themselves and for their families, friends and carers.

“There is also a serious financial imperative to stop bed blocking. The Commons Public Accounts Committee has previously estimated that bed blocking costs the NHS £170 million every year. An NHS hospital bed costs the NHS around £1,750 – £2,100 for a week’s stay. In contrast, the average cost of residential care is just under £500 a week, while nursing homes cost around £700 a week. Providing social care at home, such as helping older people with eating and washing, costs on average around £208 per week.

“Good quality post-discharge services are vital to support older people who are recovering and re-establishing their independence at home, but even with these additional costs, the overall figure for care at home is significantly lower than the cost of keeping older people in hospital.”

While last November, writing about the additional £2bn announced in the CSR, Age UK wrote that it:

“… barely covers the CSR-created hole in local authority care spending and so we predict a small overall drop in funding over the next four years, threatening to turn this problem into a disaster. Reform to the care system is urgent.”

Adding:

“Any cuts in funding for care support inevitably heap more work onto the shoulders of informal carers who often experience poor health themselves. Age UK has pushed for greater financial, practical and emotional support as part of our Older Carers Campaign - the increased budget available for respite care is a good first step.

“Carers often make great personal and financial scarifies to care for their loved ones, saving the economy an estimated £87 billion a year.”

http://twitter.com/sherwoodhealth/status/40723593658765312 Sherwood Healthcare

Another day, another false economy: The avoidable bed-blocking crisis – Left Foot Forward http://ff.im/-yJku0
http://twitter.com/maturenews/status/40727499839111168 maturenews

Another day, another false economy: The avoidable bed-blocking …: Providing social care at … http://bit.ly/fiFwCd GoogleBlog Elderly
http://twitter.com/falseecon/status/40729945269469184 False Economy

RT @leftfootfwd Another day, another false economy: The avoidable bed-blocking crisis: http://bit.ly/hGWYE5 by @ShamikDas #FalseEconomy
http://twitter.com/yorkierosie/status/40730377748217857 yorkierosie

RT @FalseEcon: RT @leftfootfwd Another day, another false economy: The avoidable bed-blocking crisis: http://bit.ly/hGWYE5 by @ShamikDas …
http://twitter.com/lewsosnhs/status/40731172824682496 lewsosnhs

RT @FalseEcon: RT @leftfootfwd Another day, another false economy: The avoidable bed-blocking crisis: http://bit.ly/hGWYE5 by @ShamikDas …
http://twitter.com/savethenhs/status/40731211722661888 Save The NHS

RT @leftfootfwd Another day, another false economy: The avoidable bed-blocking crisis: http://bit.ly/hGWYE5 by @shamikdas #savethenns
http://twitter.com/oxkev/status/40731274960183296 Oxford Kevin

RT @leftfootfwd The avoidable bed-blocking crisis: http://bit.ly/hGWYE5 << Labour's underfunding of care homes for elderly has consequences
http://twitter.com/4free4u/status/40734666080124928 For Free

Another day, another false economy: The avoidable bed-blocking crisis http://bit.ly/fXWLHj
http://twitter.com/hlcheathrow/status/40761449135476736 hlcheathrow

RT @FalseEcon: RT @leftfootfwd Another day, another false economy: The avoidable bed-blocking crisis: http://bit.ly/hGWYE5 by @ShamikDas …
http://twitter.com/oldmankelv/status/40781114394017792 Kelvin John Edge

RT @FalseEcon: RT @leftfootfwd Another day, another false economy: The avoidable bed-blocking crisis: http://bit.ly/hGWYE5 by @ShamikDas …
Anon E Mouse

Left Foot Forward – Another day, another false story….

http://www.spectator.co.uk/coffeehouse/6725008/50000-nhs-jobs-to-go-apparently.thtml

No wonder Labour are not achieving the types of poll leads they should be whilst making up stories like this one.

People aren’t stupid Shamik and you shouldn’t try to treat them as such…
http://twitter.com/myinfamy/status/40904065726685184 Daniel Pitt

Another day, another false economy: The avoidable NHS bed-blocking crisis http://bit.ly/hGWYE5 #ConDemNation
EON

“People aren’t stupid..”, because when it comes to current tory policy the figures are unnecessary. They don’t need to stack up.

When, like the Tories, you’re in the business of cutting back services in order to make them deliberately fail, eventaully allowing ‘others’ to step in to make them ‘work’, using figures to prove that becomes a meaningless exercise. It just all becomes apparent.

The scale of horror stories can go through the roof, because the tories have changed the goal posts. Truth has become irrelevent. You do, what you will do. Justification is no longer part of the end game.
Anon E Mouse

EON – You have totally missed my point. This article is completely untrue – just a misleading pack of lies.

It is built around a deceitful false premise.

Did you actually check the link before posting your completely irrelevant remark?

(Oh and the first private operations in the NHS were done under Labour in 2004 btw)
scandalousbill

Anon,

You say:

“This article is completely untrue – just a misleading pack of lies.

It is built around a deceitful false premise.”

I think that is a little extreme. The Spectator article you cite is more spin than substance.

Hoskin and Blackburn focus their position on distinction between natural wastage and compulsory redundancies and offer the following statement.

“There are also substantial inconsistencies in the False Economy report: counting a doctor who has moved from one hospital to another as a job cut; counting unfilled vacancies as a job cut; and so on. But more misleading still is the emphasis on “cuts to frontline services,” with little clarification of how many compulsory redundancies are being inflicted on managerial staff and how many on doctors and nurses…”

First point is staff reductions by attrition are still reductions. If you curtail recruitment, implement hiring freezes, etc. and vacant position are left unfilled, this is a staff reduction. The function of that position either goes to existing workloads or is not accomplished. Similarly, if a position goes when an individual who performs it retires, again, this is a reduction, and again impacting workloads and service delivery.

Unless it can be demonstrated that these positions were previously all filled by jobsmiths who loitered around the water cooler all day or played video games etc., the potential for service deterioration is quite high. To maintain that skilled professionals add nothing to the organization is simply and ideologically clad prejudice, not an analysis. I have no doubt that the authors of the article would wax lyrical for hours on end about their important contributions to the organization and journalism in general, but public sector workers, on the other hand, are all tits on a bull. Bullocks.

Hoskin and Blackburn maintain that the number of cuts in managerial staff will be offset by the increase in the number of doctors. But is it not also true that under the new legislation, the GPs will assume the bulk of management functions within the NHS? Were all these previous managers useless? Are all of the new doctors skilled administrators?

Given the radical change to be brought about by the new legislation, the risk to service delivery is significant. It has never been the case in any business that wholesale change is simply a matter of using the old system on Monday and the new system on Tuesday. The impacts on change management, business practice and procedure all imply significant risk to service delivery and business continuity. The risk of chaotic administration is quite high and, IMHO, the TUC assessments to date have merely scratched the surface of changes that will be problematic for years to come.
Mr. Sensible

Complete faulse economy.
http://www.leftfootforward.org/2011/02/yet-more-evidence-of-cuts-to-schools-and-hospitals/ Yet more evidence of cuts to schools and hospitals | Left Foot Forward

[...] it was revealed that more than 50,000 NHS jobs faced the axe, while only yesterday a study warned of a rise in bed-blocking, with more beds being filled by elderly people well enough to be in [...]
Anon E Mouse

scandalousbill – The impression this article gives is the Labour doom monger stuff – the majority of these jobs will go through natural wastage – a good thing.

All the author is doing is jumping on the scare story nonsense.

Of course not all the administrators are useless but a shedload are. A friend works for a hospital in Hereford and there are four levels of management effectively doing the same job with PCT’s and the like.

Four years from now when the world hasn’t ended Labour will simply not look credible…
http://abetternhs.wordpress.com/2011/04/14/the-role-of-the-nhs-and-the-health-of-the-nation/ The role of the NHS and the health of the nation | Abetternhs's Blog

[...] people who have nowhere else to turn. Cuts to social care, reported in several papers, mean that elderly patients have to stay in hospital wards designed for critically ill patients at a far greater cost than community care adding to the burden [...]