We’re expecting a statement from @theresecoffey on hospital discharge today. It certainly needs urgent action but a thorough plan will require more than just short term £££ and a focus on more than just #socialcare. A quick thread with some stats.
Historically, delayed discharges have not been mainly been due to #socialcare. Before COVID-19, it was responsible for only a THIRD of delays (the biggest issue: home care packages). The rest were due to NHS issues. There are no recent stats on this NHS/socialcare split though.
Have things got worse for #socialcare since then? Yes - there are fewer staff. The vacancy rate rose to 10.7% in 2021/22 (and may now be even worse). The biggest problem is home care, with a 13.2% vacancy rate. All this might well well be pushing up #socialcare delays. 
What can be done about vacancies? Pay is critical; staff can get more in supermarkets. Tackling it is tough in the short term; paying bonuses/increasing underlying pay via local authorities contracts is probably the best option, although hard to evidence. kingsfund.org.uk/blog/2022/08/h…
What other, shorter term options are there? During Covid, to free up beds, the NHS paid for the first 6 weeks of #socialcare for people leaving hospital. This built on a ‘discharge to assess’ approach in which people were assessed for care needs only after they’d left hospital.
The discharge fund cost around £500m every 6 months. It helped, not least because it cut NHS/council wrangles about who pays for care. It ended in March 2022 (ICSs are supposed to keep the approach but without the extra £££).
But the discharge fund had issues. The £££ didn’t resolve the lack of NHS community capacity (and remember the NHS accounted for two thirds of delays before Covid). And there were persistent concerns that speed of discharge sometimes led to poorer outcomes for people.
Tackling discharge has also been a key focus of the Better Care Fund since it began in 2015. It requires #socialcare and the NHS (now via ICSs) to pool budgets to improve local discharge practice. It has improved local partnership working but remains a small % of overall spend.
Together, this means that tackling discharge requires a long-term plan as well as short-term funding. It needs to address the wider funding issues in #socialcare; develop a #socialcare workforce strategy, including pay; boost NHS community capacity; improve partnership working.
We’ll find out later this morning whether @theresecoffey has grasped all this or whether we remain stuck in a loop of short term finance to alleviate winter crises but with no overall strategy to tackle the deep rooted problems in #socialcare that contribute to discharge issues.
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