Emergency admissions are backed up at the Royal Sussex County Hospital, in Brighton, as the council and NHS struggle to arrange care packages.
And the problems resulting from too many people stuck in hospital – delaying new and emergency admissions – were raised when Brighton and Hove City Council’s Health Overview and Scrutiny Committee met this week.
Older People’s Council representative Michael Whitty asked for details from Brighton and Hove health chiefs about how many people are stuck in hospital because they are waiting for care packages.
He spoke before the Health Overview and Scrutiny Committee discussed the “Sussex Winter Plan” which highlighted concerns about delayed admissions because of bed blocking.
The winter plan report said that the Royal Sussex had patients who were ready to leave hospital but could not go home – and this was causing delays in the accident and emergency (A&E) department.
The report said: “The challenge to maintaining performance is also associated with an increased number of people who are ready to be discharged but are delayed which reduces the ability to admit patients through the emergency department.
“The Royal Sussex emergency department is small and often congested, with challenges admitting patients into hospital beds. This also results in long waits for patients before they are transferred to the wards.”
The hospital is run by University Hospitals Sussex NHS Foundation Trust – and the trust’s deputy chief executive and chief operating officer Andy Heeps answered questions at the town hall meeting.
Dr Heeps said that measures were in place to ensure emergency patients were admitted in a timely way, particularly if there was a major incident. Those measures included diverting ambulances to Worthing Hospital if the Royal Sussex was at capacity.
Elective and planned work was also being redirected to Queen Victoria Hospital, in East Grinstead, he said.
At the meeting last Wednesday (23 November), Labour councillor Clare Moonan asked about delayed discharges for the medically fit – also known as bed blocking.
Councillor Moonan said: “In previous winters this has been a real tension point. Someone is ready to leave hospital medically but either their care package at home or their residential care is not ready for whatever reason.
“There has been purchasing of beds in different parts of the system which has created more tension. Has that been sorted out?”
The council’s executive director for health and adult social care Rob Persey said that the number of people waiting for care packages was higher than he would like.
Mr Persey said that there were people waiting for care both in the community and in hospital.
He said: “There is some movement with home care providers at the moment. We are moving people every day on to packages of care in the community. There are people who are delayed and waiting.
“There is a national problem with the challenges to the home care market. It is not just being felt here.
“The challenge is it’s difficult to say how many are waiting and how long they’ve been waiting because it depends on the individual and the packages of care. There is an issue with the more complex packages.
“Our numbers are higher than we would like them to be. They are lower than they were three to four weeks ago, in double digits, not triple digits.”
Brighton and Hove City Council was asked to provide the figures but had not replied by the time of publication.
Mr Persey added that the relationship between adult social care and the NHS had improved over the past five years.
He said: “Discussions five years ago no longer feel a ‘them and us’. We are all working together, recognising challenges in social care, and conversation is mature as we’re working on solutions.
“Some of the problems are beyond an easy resolution. But we do the best we can. We will work this winter with NHS colleagues and agree on how we will spend additional monies that come forth.
“This will involve buying bed capacity. There is the recognition it’s not just about beds. It’s about getting more home care and stopping people coming through the system at the front door.”
“A Stich in Time Saves 999”
We have plenty of methods available to create a proactive preventive approach to healthcare. Urgent Treatment at Home Teams, Pharmacist Prescribers, and Paramedic Practitioners to name a few.