Elderly patients to receive cash to speed up hospital discharge

Elderly people in the United Kingdom are to receive direct cash payments to fund their own home care in an attempt to reduce delayed discharges or “bed blocking.”

The announcement by the health secretary, Alan Milburn, came after the publication of a report by the House of Commons Health Select Committee that questioned the reliability of Department of Health data showing declining rates of delayed discharges of patients aged over 75—from 15.7% of discharges in September 1997 to 12.0% in September 2001.

Under the new scheme patients over 65 will be given payments according to their need to fund extra nursing care or adaptations to their homes, such as ramps, rails, or stair lifts.

The initiative is to be funded from the £1bn ($1.6bn; €1.6bn) set aside for elderly people from the last comprehensive spending review.

The government sees the scheme as promoting patients' choice. However, critics of the scheme see the drive to have more elderly people cared for in their own homes as ignoring the real problem facing the elderly: that many private nursing homes have closed because of restrictions on council spending.

According to the committee's report, 30% of delayed discharges could be attributed to waits for placement in care homes, either because of a lack of a suitable place for their needs or because the home of choice had no vacancies. The committee concluded there had been a net loss of 34200 care home places across local authority, private, and voluntary providers between 1997 and 2001.

However, the committee was not in favour of a rapid development of further residential and nursing home capacity. Too much effort was being put into developing “more of the same” rather than into providing the most appropriate care for people and “developing the necessary alternative service models to ensure that the right care, in the right place, at the right time, is available.”

The committee made 37 recommendations on the issue of delayed discharges. They supported the government's pledge to create an extra 5000 intermediate care beds, as long as this did not simply involve “rebadging” existing services as intermediate care in order to qualify for funding.

The committee's final conclusion was that health and social services should be much more integrated.

David Hinchliffe, chairman of the health select committee, said, “I never cease to be amazed at the problems caused by the Berlin wall between the two services. I firmly believe it is time this is artificial.”