Hospitals overflowing with patients staying in beds amid social care crisis
Emily Morgan reports on the deep problems affecting hospitals across the country
"Guilty. I feel guilty… you feel like you’re lingering, but it’s not your fault."
Those are the words of Paul Gallimore who has been in University Hospital Southampton since the end of August.
He’s been medically fit to leave for weeks but can’t, because he’s waiting for the city council to arrange a care package for him.
When I met him he explained he needs carers because he’s lost so much muscle, he can’t walk now.
Paul isn’t stupid, he’s 59 and knows he’s taking up a bed in a very busy hospital, which is why he says he feels guilty. I put it to him that it’s not his fault and he concedes it’s the system that isn’t working but that doesn’t stop him worrying his presence on the ward impacts someone else’s care.
I’m telling Paul’s story because it is typical of thousands of patients in hospitals across the country.
In fact, there are 13,600 patients ready to be discharged and in Southampton alone there are more than 200, that’s 17% of the hospital’s beds.
I am also telling Paul’s story because it helps to explain why ambulance wait times are so poor, why patients are waiting on trolleys in A&E departments and why waiting lists for elective surgery are still rising and not falling.
'Emotionally I've given up caring... it's letting all of us down'
The fact that Paul is waiting for a care package is pretty much the root cause of all of those problems. He is indeed taking up a bed which reduces the number of other patients who can get in.
The question everyone asks is, why is he waiting? Why does it take so long for councils to arrange care at home or find residential places in homes?
I asked James Grant, who works for the council in social services; he said it’s because there’s a shortage of care workers and there is increased demand for care because people are suffering from more complex issues.
In Paul’s case it is highly likely that they can’t find the care staff to look after him.
Others are simply waiting for a room to come free in a care home which is full or for their house to be fitted with equipment that will enable them to go home.
James tells me his staff are working flat out and taking on new and different roles all the time to help cover the gaps but it’s a never ending task.
The next question then is why not recruit more care workers, pay them more or build more residential care homes to speed up the process and free up beds?
I get the answers from Councillor Lorna Fielker, who’s in charge of Adult Social Care at Southampton City Council and they’re not optimistic. She’d love to, she says, but she can’t; ‘where would the money come from?’
Lorna showed me her budget for this year; of the £534 million at her disposal, she spends £80 million on adult social care.
Isn’t that enough to recruit more people I ask? No she says, it’s not even enough to cover the current costs.
In fact she needs to find savings of around £46 million (across the whole budget) next year because of inflationary costs and those savings have to be found everywhere, from waste costs to street lighting.
So I ask if she’s asked for more money from central government? Of course she has, she says.
The government have offered councils £500 million to help recruit more staff and help with discharge costs but when I spoke to her last week she still hadn’t seen a penny of that.
Councils will also get an extra billion pounds next year to help with discharging patients but until Lorna knows exactly how much of that she’ll get, she can’t really budget for it.
The long and short of it is that social care needs reforming.
Successive governments have failed to overhaul it and even the current government has just announced reform is being pushed back another two years.
What is happening in hospitals today is the consequence of failed reform and underfunding. Lorna says grants that come periodically are useful but they need long term social care funding so they can budget for more staff, pay rises and an increase in capacity in residential care.
Critics point out that governments for years have failed to grapple with our ageing population and invest to meet demand.
The simple fact is hospitals need social care to work or they will ultimately slowly grind to a halt.
Isn’t the risk of that worth acting on?
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