Coroners in the United Kingdom warned Health Secretary Wes Streeting over the dramatic impact of a shortage of beds and service provision on the NHS, as several patients have previously died, according to The Guardian.
Coroners sent two reports to the Department of Health and Social Care (DHSC) last month on preventing future deaths (PFDs). The report said failure to discharge patients at two hospitals led to the deaths of other patients waiting for treatment, while a significant ambulance delay led to deaths.
The PFD report concerned a patient from Manchester who remained in hospital for a month after being ready to be discharged due to difficulties in finding a suitable nursing home place during the Christmas holidays last year. “The inquest heard evidence that it meant that an acute bed was not available creating delays in allocating beds to patients requiring admission,” the report said.
In another case, a male died as a result of an extraordinary ambulance delay caused by a systemic failure across the health and social care system, according to a PFD report by Guy Davies, assistant coroner for Cornwall and the Isles of Sillie. The inquest believes a total ambulance delay of almost 19 hours may have caused the death. When the ambulance arrived at Royal Cornwall Hospital in Truro, there were 11 other people in the queue. The emergency department is designed for 44 patients but had capacity for 56.
The shortage of available beds was the result of patients being ready to be discharged but having to stay in hospital due to “inadequate social care provision, community hospital provision and primary healthcare support,” according to the report.
The DHSC said: “Our deepest sympathies are with all those impacted by these tragic cases. It is important we learn lessons from PFD reports, and we will consider these reports carefully before responding. We are committed to reforming the sector and, as set out in the manifesto, will take steps to create a national care service, to improve consistency of care across the country, and will establish a fair pay agreement for care professionals.”
Promises failed
The Labour Party stated in an election pledge its intention to create a national care service. But the only concrete commitment to this was a fair pay agreement for adult care, which was not in line with the programme detailed in last year’s report by the Fabian Society think tank, commissioned by Labour. Following its victory, Labour scrapped the long-delayed Dilnot reforms in favour of funding for care costs, but announced nothing more.
Ben Cooper, research director of the Fabian Society and co-author of last year’s report, said: “Too many people are stuck in hospital, unable to leave due to a lack of social care and support in the community. This is felt throughout the NHS, with worsening wait times for ambulances, and in A&E, and devastating consequences for patients. Fourteen years of Conservative failure to act 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 care service. Social care in England needs comprehensive reform, so that everyone has access to support when they need it, including when they leave hospital. If the government doesn’t start to act now, wait times for ambulances, A&E and other care will not fall and the NHS will continue to struggle. The government should prioritise a long-term plan on social care, alongside its 10-year plan on the NHS, he added.
Davies, for his part, emphasised the fragmented structure of the adult care system, stating the following: “There is no single organisation with responsibility to ensure that the provision of social care is sufficient to avoid delayed discharges leading to ambulance delays.” He added: “The obligation upon local authorities is limited to a requirement to promote the market.”
A Cornwall council spokesperson said: “Despite the national challenges, which are well recognised, … and the continued delays around the national policy reforms, Cornwall council has made significant investment in adult social care and is delivering new capacity across a range of services with our providers. We are also working very hard to attract more people into Cornwall’s care sector.”
