INCREASES in Hospital bed-blocking are the result of a lack of “joined-up processes” within the Health Department, according to the chair of the Jersey Care Federation.
As government figures show a rise in “delayed discharges”, with 35 patients who were medically fit to be released but unable to be discharged still at the Hospital, Cheryl Kenealy challenged claims that this was mainly owing to staff shortages in the care sector.
“When it comes to people bed-blocking because there’s no capacity within the agencies in the Island, that isn’t true at all,” she said.
“There are some significant issues within the Hospital and the social work team where there’s no joined-up referral process, and the packages of care that need to be provided for people in hospital who want to come home are not necessarily put out to all the providers.”
She added: “There are beds available in different care homes, so the reason that people are not being discharged is a lack of communication between the discharge co-ordinators and the social workers.”
Ms Kenealy’s claim was disputed by the government, which said that her words were not supported by evidence collected each week.
Andy Weir, director of mental health and adult social care for Health and Community Services, said: “While there might be some beds available in some homes, frequently these are not beds that are available to meet the needs of the people who are waiting for discharge. There is a clear process for discharge planning, which has been supported by the development of a dedicated discharge team of a nurse and two social workers.”
However, he accepted that there was “further work to be done to develop the discharge planning and discharge team”.
He said there was no doubt that a lack of availability within the care sector played a significant part in delayed discharge.
“The only way this will be addressed is to further improve joint working across the Hospital, social care and the care sector to address the various factors that impact on this,” Mr Weir added.
The latest figures show that bed-blocking has increased in recent weeks compared with the same period last year. Over six weeks from 11 September 2022, the average number of patients occupying beds when medically fit to be discharged was 18.5, compared to 32 in 2023.
Reasons for this “included waiting for availability of beds in nursing or residential homes; awaiting specialist placements; or awaiting assessment or availability of care packages within their home”, Mr Weir said.
Ms Kenealy also claimed that problems were being exacerbated by patients having to be re-admitted because of problems with their discharge.
“Often the people who are looking to be discharged aren’t medically fit, so a lot of people who are discharged end up being readmitted because there’s been a failed discharge, or the discharge took place too quickly, or wasn’t appropriate at the time,” she said.
September’s readmission rate was 18% – 8% above the government’s performance indicator target, figures show.
Asked to comment on the claim that patients who were not medically fit for release had been discharged only to be readmitted, Mr Weir said: “Discharge is a clinical decision, which is most frequently made by the multi-disciplinary team looking after the person in the Hospital.
“Readmissions are reviewed by the relevant clinical areas. It should be noted that the readmission data include patients who were readmitted for a different condition from that for which they were initially admitted.”
He added that further work was taking place to develop a number of other potential solutions to improve bed-blocking, moves which he said the department would seek to implement as part of the winter planning process. One such measure, he added, included the development of a “patient choice policy” to support discharge.
