Health Secretary Wes Streeting has been urged to speed up reforms to the adult care system following patient deaths, after two coroners warned him of the impact insufficient care beds and services are having on the NHS.
Last month coroners sent two Prevention of Future Deaths (PFD) reports to the Department of Health and Social Care (DHSC) after the inability to discharge patients at two hospitals was linked to the deaths of others awaiting treatment.
In the first case, a man died “following a grossly excessive ambulance delay which was due to a systemic failure relating to the entire health and social care system,” according to the PFD report by Guy Davies, assistant coroner for Cornwall and the Isles of Scilly. .
The total ambulance delay of almost 19 hours was assessed by the inquest as “possible cause of death”.
The investigation found that when the ambulance reached the Royal Cornwall Hospital in Truro, 11 others were queuing to transfer patients to the emergency room, which was built to house 44 patients but was holding 56.
The lack of available beds was the result of patients being ready for discharge but being forced to remain in hospital due to “inadequate social care provision, community hospitals and primary healthcare support”.
Labour’s election manifesto promised to create a national care service, but the only specific commitment to this was a fair pay deal in adult care, which falls short of the program outlined in a Labor-commissioned think tank report last year Fabian Society.
Since the election, the Labor government has abandoned the long-delayed Dilnot reforms to finance healthcare costs, but has announced little else.
“Too many people are stuck in hospital and unable to leave due to a lack of social care and support in the community,” said Ben Cooper, research manager at the Fabian Society and co-author of last year’s report. “This is being felt across the NHS, with ever-worsening ambulance and emergency department wait times, and devastating consequences for patients. Fourteen years of Conservative inability to take action on social care has contributed to a significant NHS challenge for this government.
“Ultimately, the Government’s promise of an NHS fit for the future requires a national healthcare service. Social care in England needs comprehensive reform so that everyone can access support when they need it, including when they leave hospital.
“If the government does not act now, waiting times for ambulances, emergency rooms and other care will not decrease and the NHS will continue to struggle. The Government must prioritize a long-term plan for social care, alongside its 10-year plan for the NHS.”
In his report, Davies highlighted the fragmented structure of the adult care system. “There is no single organization responsible for ensuring that the provision of social care is sufficient to prevent delayed discharges that lead to ambulance delays,” he wrote. “The obligation for local authorities is limited to a requirement to promote the market.”
after newsletter promotion
A spokesperson for Cornwall Council said: “Despite the national challenges, which are well recognised, … and continued delays around national policy reforms, Cornwall Council has made significant investment in adult social care and is delivering new capacity for a range of services with our providers. We are also working very hard to attract more people into the healthcare sector in Cornwall.”
The second PFD report involved a patient in Manchester who was kept in hospital for a month after being ready for discharge because he had difficulty finding a suitable place in a nursing home over the Christmas period last year.
“The investigation found evidence that this meant there was no acute bed available, causing delays in allocating beds to patients requiring admission,” the report said.
The DHSC said: “Our deepest condolences go out to all those affected by these tragic cases.
It is important that we learn from the PFD reports, and we will consider these reports carefully before responding.
“We are committed to transforming the sector and, as set out in the manifesto, will take steps to create a national healthcare service, improve the consistency of care across the country and deliver a fair pay deal for healthcare professionals. ”
