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Health secretary Alan Milburn has announced a transfer of an extra£100m over the next three years to social servic...
Health secretary Alan Milburn has announced a transfer of an extra£100m over the next three years to social services for each full year of operation of the new scheme to tackle delayed discharges.

Too many patients are delayed in hospital because their social services do not provide them with care in the community when they are ready to leave hospital. Under the new system, the costs of care will pass to social services when a patient is ready leave a hospital. If social services do not provide patients with an alternative to hospital care, they will have to pay the hospital for the costs it incurs.

The maximum cost that social services would face in payments to hospitals under this Bill would be£100m in any one year, assuming that councils make no progress whatsoever beyond the targets they have already set themselves to reduce delayed discharges.

Speaking during second reading of the Community Care (Delayed Discharges etc.) Bill yesterday, Mr Milburn said:

'I call tell the House I have decided, for each of the next three years, to transfer an extra£100m - on top of the resources already made available - from the NHS budget to social services for each full year in which the scheme operates.

'I am doing so in order to provide a positive incentive to make the system work. This extra£100m will now enable individual councils to gain, not lose, from the system provided, of course, they make available the community services needed to reduce delayed discharges from hospitals. Hospitals can gain too. As social services reduce the pressures on hospitals, their costs will fall.

'My intention is not to punish local government but to pursue a real and sustained reduction in delayed discharge. There can now be no excuse for social services not to fulfil their responsibilities to older people.'

Key points of the Bill:

It creates a strong financial incentive for local authorities to assess individuals who are in hospital and make provision for any community care services that they may need, as quickly as possible. This means that more people will be in the most appropriate care setting for their needs;

It means that certain community equipment (hoists, rails, ramps etc) and intermediate care (respite and rehabilitation care provided in a variety of settings) will now be free, simplifying the existing system and making it more user friendly. This also makes it easier for PCTs and local authorities to work together to provide these services quickly in partnership;

It promotes the independence of older people by creating incentives for them to be transferred from an acute ward (where they are at risk of losing their independence) to a more appropriate community setting as soon as they are ready for discharge;

It places a duty on NHS trusts to notify local authorities as soon as it becomes apparent that a patient may require community care services upon discharge. Local Authorities and the NHS are required to work together to determine the services that an individual needs; and

It creates an incentive for local authorities to move patients from acute beds to more appropriate care. The Bill will free up vital NHS capacity, which will allow for more patients to be treated.


1. The intention to introduce a system of reimbursement was announced in 'Delivering the NHS Plan' in April and is based on a system used in Scandinavia that has had a major impact on reducing delayed discharges.

2. The government is committed to ending widespread delayed discharges by 2004 and investment and reform of older people's services over the next three years will help to achieve that. The NHS, social services, independent and voluntary sectors have already started to form partnerships following the distribution of the£300m Building Capacity Grant to local authorities last October to tackle delayed discharges. This money has already helped to reduce the number of people over 75 who are stuck in hospital.

3. Social services will receive in real terms a 6% increase in funding over the next three years. By 2006 older people's services will receive an extra£1bn a year to pay for intensive home care packages, extra care housing, community equipment, services for carers, intermediate care and an expansion of the direct payments scheme.

4. With the extra funding councils will have the resources to put in place the volume and range of services needed to provide older people with the care packages they need to leave hospital on time.

5. The reimbursement charge will be set at a fair daily rate. In the original consultation document the figure of£100 per day was suggested, and£120 in the south-east, responses to the consultation suggested that this was a fair amount. The exact amount of charge will be laid out in regulations, on which we will be consulting shortly.

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