Hospitals have become dangerously full and discharge patients too soon as a direct result of “political maladministration” by successive governments, according to a committee of MPs.
The failure to join health and social care services means that one in five patients are at risk of either getting stuck in hospital or being released before they are fit to go, according to a report by the Commons public administration and constitutional affairs select committee (PACAC).
So-called bedblocking costs the NHS in England about £820m a year, according to National Audit Office estimates.
The cross-party committee is highly critical of governments down the years for allowing two public services that need to work closely together to remain separate. “At a structural level, the historic split between health and social care means that interdependent services are being managed and funded separately. We consider this to be political maladministration,” the committee says in a report about unsafe patient discharges from hospital.
The MPs blame the split for creating a situation in which many hospitals become overcrowded and send patients home before they are fit to leave, in order to free up beds. “Pressures on resources and capacity within hospitals are leading to worrying and unsafe discharge practices,” the report says.
“Hospital staff seem to feel pressured to discharge patients before it is safe to do so,” said Bernard Jenkin, the Conservative MP who chairs the committee. “Hospital leadership must reassure their staff that organisational pressures never take priority over person-centred care.”
NHS staff worried that patients are being let go too quickly should report their concerns without fearing consequences from their employer, he added.
The committee also criticises the NHS for having made too little progress on unsafe discharges since reports by Healthwatch England, the National Audit Office and Commons public accounts committee highlighted the problem. “Despite increased attention to the issue, it remains a persistent problem,” the report added.
The committee was responding to earlier revelations by Dame Julie Mellor, the NHS ombudsman, that patients sent home too soon are at risk of being readmitted as emergencies and even of dying, and that inadequate social care is often behind fit patients’ departure being delayed.
Mellor said: “These shocking failures will continue to happen unless the government tackles the heart of the problem – the chronic underfunding of social care which is piling excruciating pressure on the NHS, leaving vulnerable patients without a lifeline.”
A Department of Health spokeswoman insisted that the current government was spending large sums integrating health and social care. “Patients should only be discharged from hospital when it’s clinically appropriate and safe for them and their families, and the best way to ensure that is to meaningfully integrate health and social care. We are investing billions to do so over the course of this parliament to improve the experience of patients, many of whom will be vulnerable.”
Meanwhile NHS data shows that the number of GPs in England rose by just 108 last year despite the government’s high-profile pledge to expand the family doctor workforce by 5,000 by 2020. There were 41,985 of them earlier this month, compared with 41,877 in September 2015.
“These figures show that there has been woefully inadequate progress towards recruiting more GPs to cope with rising patient demand. The government is simply not on course to recruit the extra 5,000 GPs it promised at the last election,” said Dr Richard Vautrey, deputy chair of the British Medical Association’s GPs committee.
New figures from NHS Digital also showed that GPs in England may still be being paid for treating as many as 3 milion “ghost patients” – people who have died, moved home or emigrated.
While 57.3 million patients were registered with GP surgeries in March, population estimates suggest that there were just 54.3 million people living in England at the time. GP practices receive £136 for every patient on their list.
Hospital overcrowding caused by "political maladministration", say MPs
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