Belfast Telegraph

Nearly 48,000 delayed from hospital discharge in Northern Ireland at cost of £63.5m

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By Lisa Smyth

Almost 48,000 people faced delays in being discharged from Northern Ireland hospitals over a three-year period, it can be revealed.

According to official figures, more than 139,000 bed days were lost to delayed discharges between 2016/17 and 2018/19.

Statistics provided by the health trusts have also revealed the cost of delayed discharges over the three-year period stands at a staggering £63.5m.

At the same time, an increasing number of patients are waiting longer than 12 hours in emergency departments for a hospital bed to become available.

Waiting times for planned operations are also spiralling out of control — partly due to a shortage of beds in hospitals across Northern Ireland, which is being exacerbated by so-called bed-blocking.

A delayed discharge is when a patient has been assessed as being medically fit to leave hospital, but remains in a bed.

While some patients remain in hospital through their own choice after they have been declared fit to leave, the majority are forced to stay because there is no care package available in the community.

According to figures released to this newspaper after a Freedom of Information request, the greatest number of delayed discharges over the three-year period occurred in the Southern Trust, with more than 16,000 people enduring a prolonged wait to leave hospital after they were deemed fit enough to be discharged.

However, the trust with the highest number of bed days lost as a result of delayed discharges was the Belfast Trust, with 45,535 bed days racked up between 2016 and 2019.

According to think tank Kings Fund, “longer stays in hospital are associated with increased risk of infection, low mood and reduced motivation, which can affect a patient’s health after they’ve been discharged and increase their chances of readmission to hospital”.

Dr Ian Crawford
Dr Ian Crawford

The vice president of the Royal College of Emergency Medicine (RCEM) in Northern Ireland, Dr Ian Crawford, said: “A staggering 25,326 patients spent more than 12 hours in our emergency departments in 2018/19, with unprecedented risks to quality of care and patient safety.

“This was as a direct consequence of inadequate and reducing capacity in the face of increasing demand.

“The extraordinary number of bed days lost as a result of delayed transfers of care only compounds the lack of functional capacity, as a result of the reduction in the number of hospital beds in Northern Ireland by around 30% since 2005/06.

Paula Bradshaw
Paula Bradshaw

“Consequently, bed occupancy is running at or beyond 100% in core specialties such as general internal medicine and care of the elderly.”

Dr Crawford repeated a call by RCEM for investment to increase social care, along with staffing and the number of acute hospital beds that he said are fundamentally required.

He added: “Lastly, regularly published data relating to delayed transfers of care is publicly available for Scotland, England and Wales.

“This should also be the case in Northern Ireland — it should not require a Freedom of Information request to bring this information to our attention.”

Alliance Party health spokeswoman Paula Bradshaw said more funding of the community sector is essential, as well as an increase in the likes of physiotherapists, pharmacists, social workers and occupational therapists.

She said: “The need for appropriate levels of targeted and appropriate care and treatment cannot be under-estimated.”

Meanwhile, Dr Tom Black, chair of the British Medical Association (BMA) Northern Ireland Council, said that additional funding for the likes of GP services and community nursing is essential.

In a statement on behalf of the health and social care system, a spokeswoman said: “Growing numbers of people are living longer with complex needs and this is why the reform of adult care and support project has been tasked with identifying and implementing necessary reforms to enhance the support available in communities.”

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