Belfast Telegraph

Patient kept in hospital bed for two years after being declared well enough to go home

30,000 unnecessary days spent in hospital

By Adrian Rutherford and Victoria O'Hara

A patient was kept in a hospital bed for almost two years after they were declared well enough to return home, the Belfast Telegraph can reveal.

The astonishing case is one of the worst examples of bed-blocking in Northern Ireland in recent years.

Delayed discharges have led to people spending almost 30,000 unnecessary days in hospital – equivalent to one person taking up a bed for 80 years.

The estimated cost runs to over £10m. It has led to increased concerns at a time when Northern Ireland's health service is facing unprecedented demands on its resources.

As a crisis rages over the death of five patients at the Royal Victoria Hospital last year partly because they were not treated quickly enough, the revelations over bed-blocking will further increase pressure on health chiefs.

Some 180 hospital beds are also being cut over the next four years.

Maeve McLaughlin, who chairs the Stormont health committee, said concerns over bed-blocking were raised last year in a report by the College of Emergency Medicine.

"This was flagged up in a report which is a year old next month. It begs the question – is anyone actually listening to these concerns?"

Health Minister Edwin Poots identified bed-blocking as a key area to address when he appeared before his committee this week.

In the 21 months between April 2012 and last December, healthy patients spent 29,237 days in hospital beds.

The figures were provided after Freedom of Information requests to all five health trusts.

The figures cover only complex cases and do not include so-called simple discharges, where a patient needs minimal aftercare, meaning the true figure could be much higher.

The Department of Health target is that 90% of complex discharges take place within 48 hours.

However, in thousands of cases people are spending weeks, months and – in some instances – even years in hospital.

In the worst example, a patient in the Belfast Trust area stayed 635 additional days in hospital – almost two years.

A trust spokesperson said: "Some patients with very complex needs, for example brain injury, can be delayed due to finding the right placement or care package, usually 24/7, and very often their fitness to discharge can fluctuate."

The trust said the average cost of keeping a patient in hospital for a single day was £311.

Based on that figure, the cost of the delayed discharges would top £3.3m, although the trust said simply using average costs would not give an accurate total.

The second highest number of delayed discharges took place in the Western Trust. Some 787 people were kept in hospital, with the delays totalling 7,766 days. The average cost of keeping someone in hospital was £427 a day, putting the potential cost of bed-blockers at £3.3m.

Ms McLaughlin said: "This is an issue which is of huge concern and it requires us to look at the whole system."

Dr Mark Temple, who is a general physician and a nephrologist/renal specialist at the Royal College of Physicians in London, said: "There is an enormous amount of resource tied up in keeping a patient in an acute medical ward when they don't need to be there."

Sean Brown from the Patient and Client Council said delays in discharging people added to an already stressful time for patients and families.

"People have told us that their hospital stays should meet their care needs and only be for as long as is necessary," he said.

Appearing before the health committee on Wednesday, Mr Poots said he wanted an "aggressive" strategy to deal with bed-blocking.

"I think that is still an issue and is something that I will look to this report (RQIA) to be very aggressive in ensuring that we minimise that activity," he said.

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