More people may be spending the time between Christmas and New Year in hospitals in parts of England this year than at any time in the last decade, as National Health Service the trusts struggle to find places of social care for medically fit patients for discharge.
The latest figures for December to date show an average of 94,200 patients in hospitals across England, more than 93,000 of them in acute settings, the highest in seven winters.
Hospitals in the Southwest, Southeast, and Northwest, the areas with the highest proportion of medically fit patients who cannot be discharged due to an acute lack of social attentionThey are seeing a record number of patients.
NHS England chief executive Amanda Pritchard has admitted the health service could be facing the “most challenging winter in our history”, even worse than the height of the pandemic.
In a Christmas thank you message to staff, he said: “I always thought that as difficult as those initial waves of Covid were, and they really were, it would actually be dealing with the ongoing pressures, that could be even more difficult – that combination of getting services back at the same time we deal with the continuation of Covid and everything else that winter has in store for us.
“We are facing record demand for many services, from GP services to mental health services and of course urgent and emergency care. But despite these pressures, NHS staff rise to the challenge every day.”
The figures, which reflect the situation in the weeks leading up to December 18, show the magnitude of the challenge facing trusts, which have been asked to undertake a “expedited discharge of medically fit patients” before the ambulance strikes last week.
The NHS is experiencing a winter of discontent, with strikes by nurses and ambulance staff and multiple pressures affecting the service, including Record ambulance delays, growing waiting lists and thousands of beds required for flu patients, as the virus began to circulate widely after the Covid pandemic.
Across England, 13,697 patients were ready to be discharged but could not be sent home or to other care settings in the week to November 18, according to the NHS, equivalent to about one in seven people in the UK. hospital.
In the same week last year, that number stood at 10,694, meaning the number has risen by more than a quarter (28%) according to figures provided by the NHS.
However, the Southwest, where more than one in five patients are stuck in hospital despite being medically fit to leave, is being hit particularly hard, with 44% more patients occupying beds than the pre-Covid average.
Almost two-thirds (64%) of the region’s 14 acute hospital trusts had occupancy rates higher than the English average in December, while close to half experienced their highest levels of occupied beds for at least the last decade. .
An NHS spokesman said: “There is no doubt that the NHS is under considerable pressure – the latest figures show 19 out of 20 beds are occupied amid a rising number of hospital flu cases and that adds to the record demand on A&E, rising staff absences, and more than 13,000 patients each day in the hospital despite being medically fit for discharge.
“Thanks to the efforts of staff and our recent push on this, there has been a reduction in the number of late discharges under NHS control, and the NHS continues to work closely with social care colleagues to ensure that as many possible number of patients can get home. in time to spend Christmas and the New Year with loved ones.”
The British Medical Association doctors union said patients deserved better. Professor Philip Banfield, chairman of the council, said: “Christmas should be a time when people can spend with their families and loved ones and the thoughts of doctors and nurses will be with those who remain in hospital.”
He added: “With years of chronic underfunding and dire labor shortages in the NHS and social care, this is sadly not surprising. The capacity simply does not exist in the system to efficiently discharge people who might otherwise be cared for at home or in other settings.
“In 2023, the government cannot afford to bury its head in the sand, ignore health workers and expect patients to put up with the NHS, once the envy of the world, collapsing around them.”
The NHS Confederation, which represents hospitals, predicts that fewer patients will be in bed this Christmas than figures suggest.
Its chief executive, Matthew Taylor, said: “There will undoubtedly be patients stuck in hospital this Christmas due to the unavailability of social care packages, where they might otherwise be transferred back home or to a residential setting.
“Some NHS leaders are telling us today that the strikes have caused a slowdown in the discharge of patients from hospital. The strikes are not helping, but this has been a long-standing problem.
“That said, significant and effective preparatory work was done to discharge those who no longer need to be in NHS beds before the strikes. Although there has been a slowdown since the strikes, we think and hope that the situation may be better than described in these latest figures.”
But Taylor said more investment in social care would be needed to help free up hospital beds in the future. He said: “The NHS and social care are working closely together to improve discharge rates, but this is an ongoing challenge.
“We welcome the government’s recent additional investment in social care, but it now needs to be urgently converted into more care packages for vulnerable people who desperately need social care support. Otherwise they will continue to suffer and the NHS will continue to have too many patients occupying beds who do not need to stay in hospital.”