Under the Delayed Discharges (Community Care) Act the government has introduced a system which will see social services departments fined for every day that a person is delayed in leaving an acute hospital due to social care reasons. In Hampshire this rate has been set at £100 per person per day. From next month the system will operate in shadow without fining, ahead of it going live on 5 January 2004.
Hampshire CC has adopted a proactive approach to tackling delayed hospital discharges, allocating an extra £3.5m to support initiatives in this area such as schemes which provide people with intensive support on their return home from hospital, short stay rehabilitation beds, rapid response services which provide short term intensive care preventing people from needing to go into hospital. In addition a further £3.5m has been made available by the county council to assist older people to live at home with the appropriate and intensive support they need. Equally important, the 'ENHANCE' project being implemented with health colleagues will deliver 500 new nursing home beds across the county on local authority and health sites from autumn 2004.
All local authorities have also been allocated grants to offset the cost of fines. In recognition of Hampshire's particular needs, including its high proportion of older people, limited availability of care b eds and issues with workforce recruitment and care bed prices, the county council received the largest grant in the country, £1.2m.
While it is expected these will go a long way to reducing delays from hospital due to social care reasons - and the number of people delayed in this way have halved in the past six months - given the size of Hampshire and the turnover and volume of patients in and out of hospital, some fines are still likely. At the current level of delays due to social care reasons, currently around 50 people, these potential fines would be estimated at around £2.5 million each year.
Commenting, the county council's executive member for social care Felicity Hindson said: 'We have made excellent progress in our work with partners to put in place the necessary processes and care management procedures to meet the many demands of the new delayed discharges fining system.
'Our main concern is not just about avoiding fines, but continuing to provide and develop innovativeschemes for older people to both prevent them from needing to go into hospital and also to help them out of hospital quicker.
'Nevertheless we continue to oppose the underlying principle of fining which flies in the face of already established partnership working in this area, takes with one hand while giving with another, and continues to require enormous time, energy and resources to set up the new bureaucracy which does nothing to aid the patient.
'I wait with interest to see how the new system pans out in practice in the coming months and know staff will be striving to make it work, while continuing to ensure the needs and wellbeing of older people are at the forefront of their efforts.'
The new fining system only applies to hospital discharges which are due to social care reasons, and not those related to health sector reasons. In general social care accounts for a third of all hospital delays with health accounting for the other two thirds.
People are del ayed in their discharge from hospital for many reasons - some are waiting on specialist treatment at another hospital, some have severe health needs and are awaiting continuing health care funding, some are waiting assessment by social services, some are waiting for their 'home of choice,' while others may be waiting for social services funding.