Bed blocking

The Telegraph Health Editor, Laura Donnelly reports that hospitals have started to impose eviction notices on frail elderly patients who are unwilling or unable to move into care. When somebody is in hospital they are, by definition, ill and require care that can only be provided by medically qualified and trained staff. However once their healthcare needs have stabilized and they are no longer in need of acute healthcare, then a move from hospital is appropriate. For those individuals who are able to move home and resume normal daily living, this is a normal part of hospital discharge. For example someone with a broken leg or recovering from surgery would expect to go home, convalesce and then resume normal daily living.

For those who are elderly, frail or injured in a way that changes their life dramatically, a move home may not be practical, either because they are unable to look after themselves or because a home care package is not available. A move into a residential or nursing care setting may be appropriate to provide the security of regular meals, supportive staff and on‑call individuals. If convalescence is required, this may be a short term period of rest or re-enablement. If, however, someone has a sophisticated nursing need, then a specialist nursing home may be required and a lot of work will be involved in finding the appropriate care home and then assessing whether it has a vacancy.

For someone who relies heavily on assistance from their friends, family or professionals, a threat to discharge them from hospital is worrying and frustrating. Who is acting on their behalf? Is it an attorney, a Court appointed deputy or a concerned relative? Does this person have authority to make decisions about care, especially where someone’s capacity is impaired? Simply asking someone to leave hospital because they are medically fit to do so is often only the beginning of a greater problem. Part of the problem is that the cost of care is a great concern.

Better integrated care, social care and healthcare are crucial to understanding the issues, but questions arise about payment for the care: is NHS Continuing Health Care Funding an option? Does someone need 24 hour nursing care as the result of an accident? If so, could there be financial consequences for their future? Is the proposed move into care temporary or permanent?

It is important to have prompt discussions about these issues with the individual, the family or legally appointed representatives, such as attorneys. Early discussions regarding discharge will help people understand that care is required when they leave hospital, and it is important for them to know how this will work in practice and who is paying for it.

If you or an elderly relative need advice regarding access to health or social care provision then contact a member of our Elderly Care Team.

If you are concerned about the quality of medical treatment given to yourself or a relative, contact a member of our Medical Negligence Team on 0345 209 1055.