Blog: How do we resolve delayed hospital discharges for health and social care reasons?

Rhona Mcleod

Rhona Mcleod

Trust Housing Association’s Rhona McLeod outlines how a Housing with Care model could address the issue of delayed hospital discharges.

Delayed discharges from hospital are an ongoing problem for the NHS in Scotland, one that cost £114 million in 2013/14 alone. According to the latest monthly statistics, more than three quarters of delayed discharge cases are for health and social care reasons. These can include the lack of a suitable place in a community setting, the patient having to wait in hospital to have their social care needs assessed or delays in putting appropriate care arrangements in place. In a limited number of cases, there will also be issues with sourcing funding for social care.

The practical effect of these delays on the NHS as a whole is a significant drain on resources and a shortage of available beds. For the individual, it means remaining stuck in hospital for days or weeks longer than necessary until suitable care arrangements outside hospital have been found for them.

Trust Housing Association has been exploring potential solutions to the many cases of delayed discharge from hospital due to health and social care reasons. In particular, we have a growing number of Housing with Care developments which enable elderly tenants to continue living independently while also receiving anything from less than five hours to more than 25 hours of personal care each week.

With around 20% of health and social-care related cases delayed for more than 4 weeks, a recent independent evaluation of our Housing with Care services concluded that the Housing with Care model could offer an affordable solution to long-term delayed discharges from Scottish hospitals.

Over a three year period, this study found that more than 50 tenant admissions to acute hospitals that would have been required had the tenant been living in mainstream housing were avoided as a result of living in a Housing with Care development.

The evidence suggests that the Housing with Care model could effectively address the issue of delayed discharges both by reducing the overall number of tenant admissions to acute hospitals and by supporting more timely and effective discharge for those admitted to hospital.

A cost benefit analysis carried out as part of the independent evaluation also presents Housing with Care as a more affordable solution than residential care for local authorities, particularly for older people on lower incomes in receipt of substantial levels of personal care on a weekly basis.

One year on since the integration of health and social care in Scotland officially went live, the approach taken by the health, housing and social care sectors to addressing the issue of delayed hospital discharges will be a real acid test of whether that integration is working effectively on the ground.

Innovative solutions such as Housing with Care have a critical role to play in improving the integration of health and social care while delivering improved outcomes for the individual and potential major savings for the NHS.

  • Rhona McLeod is chief executive of Trust Housing Association