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12 Sep 2024

Opinion: Redirecting NHS funding to social care makes sense if hospital backlogs are to be tackled

Opinion: Redirecting NHS funding to social care makes sense if hospital backlogs are to be tackled
Tom Zundel, Political and Media Consultant at Bridgehead Communications, lays out the case for ending the neglect of social care in Westminster and delivering funding for a more sustainable health and social care system.

For anyone that watches even just a few minutes of news a week, the sorry state of the NHS is not a novel sight. What is clear though is that, despite record increases in spending, our healthcare system faces a crisis that is threatening its ability to provide timely and effective care.

Part of this stems from the occupants of our hospitals. Every day over 14,000 NHS hospital beds are occupied by patients who are medically fit for discharge but remain in hospitals due to a lack of appropriate social care arrangements. This situation exacerbates the backlog of hospital care and imposes a significant financial burden on the NHS. To address this issue, the Government must urgently reconsider its funding allocations, prioritise social care to reduce delayed discharges, free up hospital beds, and ultimately ease the strain on the NHS.

The scale of the problem is immense. Delayed discharges are a persistent issue, with patients fit enough to leave hospital unable to do so because the necessary social care support is unavailable. According to the Nuffield Trust, the most common cause for these delays is the lack of at-home support, particularly in social care, accounting for nearly a quarter of all cases. Almost a fifth of relevant patients are waiting for a permanent place in a nursing home.

These delays not only hinder the efficiency of the NHS but also come at a steep cost. In 2022/23, it was estimated that delayed discharges cost the NHS at least £1.7 billion, a figure that excludes indirect costs such as cancelled operations. The effect this has is exacerbated by the shrinking number of hospital beds available across the country. Over the past few decades, the number of NHS hospital beds in England has more than halved. According to the King's Fund, the UK now has one of the lowest numbers of acute beds per capita among developed countries.

Clearly, moving these patients into the community and providing adequate social care would be an essential step in delivering greater healthcare capacity to reduce the backlog of care that’s built up over the past decade. The problem is that councils, who bear the responsibility for delivering social care, are unable to take the strain.

Care home and home care services are severely underfunded, with a shortfall of around £3 billion in 2022 alone. This financial cost of rising demand for care has led to a situation where about a third of councils are uncertain if they can meet their statutory duties of care provision by 2025/26. Without central government stepping up, the persistent issue of delayed discharges may yet worsen, rather than improve.

What should be noted is that the NHS spending money towards social care is not a novel concept. The health service and Department of Health and Social Care spend approximately £9 billion annually on supporting care provision through various funding streams, including the Adult Social Care Discharge Fund and the Better Care Fund. However, this is a fraction of what is needed, especially given NHS England’s £153 billion in funding for the 2022/23 period.

Recognising that hospitals receive all the cash whilst primary and community care is starved of financing is the first step. Thankfully, it seems that milestone has been reached. Labour Health Secretary Wes Streeting has already begun the process of redirecting funds from hospitals to primary care, aiming to "fix the front door to the NHS." This move is a step in the right direction but must go further and crucially must include the social care system.

The NHS and social care have an inherently symbiotic relationship. Adding the responsibility of social care to the Department of Health was a recognition of how important the sector is as well as how closely it ties into our healthcare system. It’s time for the Government to deliver on this and put social care on an equal financial footing with our healthcare system.

 

 

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