Patients ‘warehoused’ and ‘lost in the system’ amid rush to discharge

More and more older people are being “warehoused” in inappropriate care beds, condemned unnecessarily to long-term care, and “lost” to health and care services, due to the rush to discharge from full hospitals and a lack of community rehab services, leaders have warned.

Several senior figures in community and social care have raised the issue with HSJ, warning it has been a growing concern over the past 18 months of severe system pressure following on from acute covid peaks.

The Health and Safety Investigation Branch has also raised the issue, telling HSJ inappropriate care placements are leading to harm and readmissions, while a major accountability gap remained over the safety of discharges.

The average length of hospital stay has increased compared to pre-Covid, with a big jump in those staying more than three weeks. Many in the NHS put this down to a lack of social care capacity meaning more medically fit people are stuck in hospital. 

Senior staff in community health and social care services told HSJ hospitals were increasingly demanding rapid discharges, often as part of “surge” measures when they are very full and under pressure to reduce ambulance queues. Homecare cannot be organised, and with suitable step-down and care beds also full, trusts are instead “spot purchasing” space in unsuitable homes which may be a long journey from the person’s home area, and in a different council area.

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Source: HSJ, 5 January 2023

Further reading

• HSIB interim bulletin - Harm caused by delays in transferring patients to the right place of care