CRACKPOT GOVERNMENT PLANS TO CHARGE LOCAL AUTHORITIES FOR LATE HOSPITAL DISCHARGES

12.00.00am GMT Thu 31st Oct 2002

CLLR DENISE CARR, LIBERAL DEMOCRAT SPOKESPERSON ON SOCIAL SERVICES HAS CONDEMNED GOVERNMENT PROPOSALS TO FINE LOCAL AUTHORITIES FOR "BEDBLOCKERS" – PATIENTS DELAYED IN HOSPITAL WHILE APPROPRIATE CARE SERVICES ARE ARRANGED FOR THEM.

These proposals could cost our borough £1.2 - £1.3 million pounds a year, under an incredibly bureaucratic charging, cross-charging and rebate system, which may keep the accountants happy but is unlikely to help patients.

Under the euphemism of "proactive discharge planning", doctors will be expected to notify Social Services before elective admission or at emergency admission, if a patient will require ongoing care after discharge – Social Services will then have 3 days to put together a care plan.

Once the hospital decides the patient is ready and safe for discharge, the chargeable delay will be counted from the following day.

Cllr Carr says "This is yet another example of the "Whitehall knows best" Labour attitude. I am calling on Cllr Matthews, the Cabinet Member responsible for responding to the consultation on charges, to join with me in demanding that the Government think again about the damaging impact these proposals will have."

"Patients and their carers and relatives must come first. While nobody wants to be in a hospital bed for longer than absolutely necessary, it often takes time for elderly people and their families, to adjust to the idea that they will need home care services or residential or nursing care when they leave hospital."

"They should not be moved from pillar to post to meet arbitrary Government targets. If this Government is serious about working with social Services, health and housing providers to develop a range of services that meet the needs of patients and their carers."

"They should be looking at the whole system and should be;  redressing the decades of under funding of health and community care  focusing on preventative measures to help reduce the number of hospital admissions, and  building on the effective joint working between the services which we in Richmond are making happen through the commitment of the new Primary Care Trust, the Council and the other key stakeholders in our community."

See below for detailed briefing notes; 1. Over the last two years, the Government has provided limited extra funding through Winter Pressure monies and Capacity Building grants to encourage joint working between health and Social Services in respect of hospital discharge.

2. Richmond social Services now has two hospital based teams (one in West Middlesex, one in Kingston) to speed up joint assessments with health staff, patients and carers and the purchase/provision of suitable care services at home or in a residential setting as required. There is also an Enablement Team to provide short-term intensive support on discharge from hospital (both would work better if we could recruit the required staff).

3. Currently, delayed discharges are counted from the point at which the multi-disciplinary team agree that a patient no longer requires care in an acute setting and is safe to transfer. There are 34 delayed people (target is 13). Reasons for the delays include waiting completion of assessment, often by health staff; waiting for a place in a care home or in the care home of choice; waiting for other types of NHS care; waiting for the funding package, including NHS funding, to be agreed; waiting for necessary home adaptations/support services to be arranged.

4. The Government's proposals were issued for consultation from 29 July to 18 September, for implementation from 1 April 2003. The Association of Directors of Social Services (ADSS) have provided a detailed response, which highlights that the proposed scheme ignores the reality of the health/social care economy and the potential knock-on effects of targeting one part of the system in such a blinkered way, will divide rather than promote joint working between health and Social Services where budgets are at stake and demand is outstripping supply, will add to the risks of premature discharge, readmissions, and multiple moves for elderly people, and will reduce choice/control over the options for vulnerable people and their carers/families. (See paper by Liz Railton, Chair of the ADSS Resource Committee, 17.9.02)

5. National and local charities like Age Concern and the Carers Association are equally concerned (contact Margaret Reynolds, Age Concern Richmond 89408066 and Jean Lewis Richmond Carers Branch 8876 4133).

6. The Liberal Democrats are committed to quality public services, funded by taxation and locally commissioned and provided. At our Autumn Conference (Brighton 22-26 September) we agreed a radical new policy, based on the work of a Commission on Public Services, designed to redress the years of under funding by both Labour and Conservative governments. In particular, the party agreed to earmark National Insurance Contributions as a guaranteed NHS Contribution, to ensure better funding, ring-fenced for the health service. The Lib Dems would also:  fund pensions, unemployment and sickness benefits through general taxation  replace Council Tax with local income tax to allow local communities to determine the level of spending on community services such as community care  return business rates to local control  allow Local Authorities greater flexibility to borrow for capital investment  allow greater flexibility in public sector pay settlements to help address shortages of key workers  encourage a greater focus on public health and prevention measures  provide for fairer access to services, for example by ending charges for personal care. (See policy paper 53 "Quality, Innovation and Choice" dated September 2002 ISBN: 1 85187 685 5 £4 from Liberal Democrat Image 01252 408282