Delayed Hospital Discharges

Oral Answers to Questions — Health – in the House of Commons at 12:00 am on 15th November 2016.

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Photo of Tom Blenkinsop Tom Blenkinsop Labour, Middlesbrough South and East Cleveland 12:00 am, 15th November 2016

What assessment he has made of the effect of changes to local authority social care budgets on the level of delayed discharges from hospital.

Photo of David Mowat David Mowat The Parliamentary Under-Secretary of State for Health

The Government are giving councils access to a further £3.5 billion for social care by 2019, which will mean a real-terms increase over the lifetime of this Parliament. The causes of delayed transfers of care are complex and, frankly, vary considerably by local council.

Photo of Tom Blenkinsop Tom Blenkinsop Labour, Middlesbrough South and East Cleveland

The Care Quality Commission has commented that social care is on the verge of collapse. The Government have had six years of warnings in relation to this matter, yet they have cut £4 billion from the social care budget. Will the Secretary of State for Health be talking to his colleague the Chancellor of the Exchequer to ensure that the £4 billion is replaced in the autumn statement?

Photo of David Mowat David Mowat The Parliamentary Under-Secretary of State for Health

The system is under pressure but we also know that the best way to achieve the best results is faster integration, and not just money. I will give the hon. Gentleman an example. There is a massive disparity between councils. The best 10% of councils have 20 times fewer delayed transfers of care than the worst 10%. It is not just about money, as the budgets are not 20 times different. Indeed, many councils have been able to increase their budgets, including Middlesbrough.

Photo of Sarah Wollaston Sarah Wollaston Chair, Health and Social Care Committee, Chair, Health and Social Care Committee

The Minister is aware of the Health Committee’s concerns about the effect of underfunding of social care on the NHS. He may also be aware that there are particular concerns in my area and in the constituency of my hon. Friend Kevin Foster because of the recent Care Quality Commission rating of Mears Care as inadequate. Coming on the back of community hospital closures in Paignton, that gives grave concern to all our constituents. Will the Minister meet me and my hon. Friend the Member for Torbay to discuss this further?

Photo of David Mowat David Mowat The Parliamentary Under-Secretary of State for Health

My hon. Friend is right that there was an inadequate CQC rating for that care home. It is therefore right that the care home must either improve or go out of business. That is what the CQC regulatory environment will ensure. She makes a point about the issue with the hospital in Paignton; that is out for consultation at the moment, and I would expect the local care situation to be part of that consultation.

Photo of Barbara Keeley Barbara Keeley Shadow Minister (Mental Health and Social Care)

The National Audit Office report “Discharging older patients from hospital” said that

“there are…far too many older people in hospitals who do not need to be there”.

Delayed discharges reached a record level in September. The Minister says that this is complex, but I can tell him that the main drivers for that increase were patients waiting for home care or for a nursing home place; those issues are both related to the underfunding of social care. Does he agree with NHS England chief executive Simon Stevens that any extra funding from Government should go into social care?

Photo of David Mowat David Mowat The Parliamentary Under-Secretary of State for Health

As I said earlier, we accept that the system is under pressure, but we also make the point that there is a massive disparity between different councils. Some 13% of local authorities cause 50% of the delayed transfers of care—DETOCs. The real point is that those local authorities that go furthest and fastest in integration, with trusted assessors, early discharge planning and discharge to assess, have the most success.

Photo of Hugo Swire Hugo Swire Conservative, East Devon

Northern, Eastern and Western Devon clinical commissioning group is already consulting on the possible closure of community beds across Devon. The social care budget in East Devon, an area of elderly people, and the rest of the county is already under severe pressure. That pressure will inevitably increase if community beds are closed. Will the Secretary of State therefore commit to putting those points to the Chancellor of the Exchequer in the run-up to the autumn statement?

Photo of David Mowat David Mowat The Parliamentary Under-Secretary of State for Health

The Secretary of State has already made the point that we do not give a running commentary on the status of discussions with the Treasury, but I accept my right hon. Friend’s point about his local issue.