Published on Friday, 9th June 2017


A lot has been written lately both about delays in discharging patients from hospitals. Part of this heightened profile is simply the General Election campaign, but there is a real issue here too and it is true that across the country the system’s performance is slowly worsening.


The biggest cause of delays is hospital processes, but the domiciliary care market also plays a role. Providing personal care has always been a low paying job and is one that is difficult to find people to do. Locally, there was a noticeable tightening in the market when the new Tesco store opened by Fratton Park, as more than a few care providers decided they would rather have a job there than spending long hours helping get people out of bed, keeping them feed and clean and ensuring they take medication.


Arranging a domiciliary care package often takes time and this can create some delays. In recognition of this, the City Council is increasing its reimbursement rate to care agencies by 7.5% to near £16 per hour. Taking into account central office costs, travelling time and holidays this still implies a fairly low take home rate of pay, but it still significantly more than last year and is more than the council can really afford: the early indications are that social care will struggle to stay in budget and that making further savings next year will be challenging.


The other part of the system over which the council has some control and influence is the hospital-based discharge team. This consists of just 9 people (by way of comparison, Portsmouth Hospitals Trust has 7000) and they work as part of an integrated service led by the NHS. This new integrated structure has not been working as well as it might and the council is seeking changes.


Most of what happens in any hospital is controlled by the hospital itself and that is the case in Portsmouth. Local authority social services are a factor in delays in getting people out of hospital, but they are not the main one. A shortage of capacity in the Spinnaker and Victory step-down wards, both run by Solent NHS, is a major problem, as is the processes within the hospital itself. The council is, however, trying to influence things where it can. 


Tags: Adult Social Care, Hospital