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It's not just NHS staff who have to face the challenges of winter pressures. The social care sector also has a vital role to play in freeing up hospital beds.




In May this year, a National Audit Office (NAO) review said that 1.15 million bed days were lost to reported delayed transfers of care in acute hospitals during 2015. That's an increase of 31% since 2013 and costs the NHS £820 million per year. As winter sets in, hospitals and social workers are once again facing the perennial problem of increased pressures, against a backdrop of an ageing population and increasing hospital admissions.

"With the increase in numbers of older patients, it is critical for health and social care providers to work together to minimise the length of time that such patients spend in hospital," said the NAO report. Recommendations included identifying patients’ needs more quickly, health and social care staff working together to maintain the momentum of treatment and discharge planning, and assessment and rehabilitation of patients in their homes wherever possible.

A question of funding


However, many experts have questioned whether adequate funding and resources are there to deliver these aspirations. The NAO admits that 'workforce capacity issues in health and social care organisations are making it difficult to discharge older patients from hospital effectively'.
 
A recent report by the House of Commons Health Committee concluded that 'additional investment in community step-up/step-down beds and adult social care is essential to addressing the widespread pressures on A&E'. Responding to the report, Health Minister Philip Dunne commented, "Crucially, we are ensuring the money available to local authorities for social care will rise in the coming years – by up to £3.5bn extra in 2020." However, hopes that Chancellor Philip Hammond would announce additional spending in this year's Autumn Statement were misplaced.

Reduction in transfer delays due to social care provision


To avoid delays in transfers, complex social care packages often have to be processed at short notice, and with reducing resources this will inevitably be more of a challenge. However, according to a 2015 briefing published by the London Councils, transfer delays caused by lack of social care provision have been steadily reducing – a tribute to the hard work put in by social workers day in day out.

The importance of greater health and social care integration


There are examples of productive collaboration. In the London Borough of Newham, initiatives partnering the adult social care team with the voluntary sector and Barts Health NHS Trust have resulted in fewer delayed transfers from Newham University Hospital. For example, there's the Home and Settle programme, in which the adult social care team works with Age UK volunteers.

The Centre for Public Scrutiny has published a best practice guide to help local authorities plan for winter pressures.  Recommendations include: early discharge planning, systems to monitor patient flow, multi-disciplinary/multi-agency discharge teams and the use of trusted assessors to avoid duplication and speed up response times. 

In an uncertain world, there's one thing we can be sure of: winter will come again next year. Social workers and health workers across the UK will no doubt be hoping that, in the future, the extra pressures they face are no longer as inevitable as the season itself.

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