NHS: Unsafe Hospital Discharges

Baroness Watkins of Tavistock Excerpts

Wednesday 15th June 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, this is a difficult issue. You can lead a horse to water but you cannot make it drink. To some extent you have to rely on local people working together, and it is behaviour and culture that determine long-term sustainable improvement. If we try to force the pace beyond that at which local people are prepared to go, in the long run we may not make as much progress. In the first instance we hope that the STP process, involving all local people and giving them a framework for working together, will deliver the results we need. If it does not, we will have to revisit it.

[Baroness Watkins of Tavistock (CB)]

My Lords, could the Minister ask why the NHS has not considered funding nursing home places for people who are ready to be discharged for two or three weeks, so that they can have 24-hour care funded by the NHS while they prepare to move back home? People who live alone, in particular, are just waiting for financial assessments while reducing other people’s access to acute hospital beds, including young people who are routinely having standard operations cancelled.

[Lord Prior of Brampton]

My Lords, looking back over 20 years, the reduction in the number of what you might call step-down facilities—community hospitals and the like—has been a huge mistake. We lack step-down facilities. In America they are called skilled nursing units. The fact is that an acute hospital is not a good place to be for anyone once they are medically fit to be discharged; all the evidence suggests that it is more expensive but, more importantly, less good for the patient. I agree entirely with the noble Baroness that we need to explore avenues of discharging people earlier to nursing homes, community hospitals or, better still, back home with the right community support.