Daily Insight: Solving the problem by creating another

Data suggests that efforts to reduce delayed discharges in acute hospitals with more step-down care may have been “shunting” problems onto community services.

NHS figures, collected by the Nuffield Trust, show a leap in the number of “fit for discharge” patients in community hospitals in early January; just as the government and NHS ramped up efforts to free up beds in acute hospitals, amid a crisis in emergency care.

After the Christmas period, the government and NHS England announced a fresh push into both NHS community services and social care. On 9 January, ministers announced a specific policy – with additional funding to buy bed capacity – to encourage discharge.

The data shows that the number of “fit for discharge” patients in community hospital beds increased by 9 per cent from the final three months of 2022 to the first three months of 2023 – from 1,663 to 1,810 – with a sharp leap at the very beginning of the year. 

Nuffield Trust acting director of research Sarah Scobie said that “efforts to bring in more step-down care seem to have shunted a chunk of the acute challenge onto community services, which are already overstretched, resulting in more bottlenecks elsewhere in the system”.

Having a word

Rishi Sunak tried to draw a line under the pay negotiations with junior doctors last month, by saying the 8.8 per cent offer was “final” and there will be “no more talks on this year’s pay”.

However, HSJ revealed that “informal” talks with the British Medical Association have restarted, after weeks of silence. It comes ahead of the latest four-day strike, which starts today.

The significance and extent to which pay is being discussed in the latest talks is unclear. But the BMA will have noticed the prime minister only publicly closed the door on 2023-24, meaning there could be potential for a possible back-dated payment for last year, or for some sort of commitment relating to 2024-25.