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Wednesday, 17 April, 2002, 23:11 GMT 00:11 UK
Bed-blocking a massive problem
Hospital ward
Two million bed days are lost each year
Bed blocking could be reduced if public services worked together more effectively, a report suggests.

Edward Leigh, who chairs the Commons Committee of Public Accounts, said public agencies must stop letting down vulnerable people through their own failure to co-ordinate activities.

The committee examined what the Cabinet Office is doing to promote better joint working between public, voluntary and private sector organisations involved in delivering public services.

Its hard-hitting criticisms are made in the committee's annual report, published on Thursday.


Vulnerable people are being let down badly by public agencies failing to co-ordinate their activities properly

Edward Leigh, Public Accounts Committee chairman

A report on hospital bed management showed that two million bed days had been lost each year because of delays in discharging people who were fit to leave hospital.

Two thirds of beds were occupied by people over the age of 65 and a key factor in their delayed discharge was the difficulty in finding them places in community facilities.

This would indicate a need for better joint working between NHS agencies and social services departments, the committee suggests.

Mr Leigh said: "Vulnerable people are being let down badly by public agencies failing to co-ordinate their activities properly.

Cost evaluation

"If social services and the NHS got their collective act together, for example, they could combat delays in discharging the elderly from hospital.

"This would reduce the stress and uncertainty for patients and release hundreds of thousands of hospital bed days back into circulation."

By working together, departments can save money by removing overlaps and duplication in service delivery, says Mr Leigh.

The committee's concern is less with the process of joint working than that it should deliver sustainable improvements in public services.

Through consultation and research, departments need to assess the particular requirements of their client groups, such as the elderly.

They also need to be sure that reliable and comprehensive information will be available to determine whether sustained improvements in services are being achieved.

Mr Leigh said joint working could take a variety of forms, from establishing new organisations to having dedicated single units.

He said departments needed to establish arrangements for assessing the cost effectiveness of joint working arrangements, including the difference they make to the quality of public services and overall value for money achieved.

Difficulties ahead

The British Medical Association (BMA) strongly supports joint working to improve services for patients and vulnerable people.

It points to the fact that over the last two years, some of the extra money given to the NHS to cope with winter pressures has been used to help social service departments fund places in nursing homes.

This has enabled hospitals to discharge people who no longer need to be in hospital.

A BMA spokeswoman said: "There is tremendous scope for much more integrated working all the year round but there are some very real difficulties to be overcome.

"The report by Derek Wanless published yesterday says that health and social care are 'inextricably' linked and calls for further work to develop a 'whole systems' approach."

A recent BMA conference on intermediate care looked at this issue.

"Ideally, to provide services which are built around the needs of the individual, you would have health, social care and housing services all working together," said the spokeswoman.

The new primary care trusts which came into being on 1 April this year have the potential to commission both health and social care but they are new organisations and need time to build up the capacity and expertise to do so, she added.

See also:

01 Sep 01 | Health
The elderly care crisis
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