The latest social service performance indicators have exposed an increase in the delayed discharge of elderly patients from acute hospitals, a trend which could lead to more blocked beds this winter.
Figures published last week show that in 1998-99, across England as a whole there were 1.38 delayed discharges of people aged 75 or over per 1,000 people aged 75 or over. This increased last year to 1.52, a 10 per cent increase.
London did particularly badly. In 1998-99, its delayed discharge rate was 1.89.Those rose last year to 2.16: a 15 per cent increase.
But the figures show that elderly people are being better supported in their own homes and are less likely to move into residential or nursing homes.
The growth rate for emergency admissions of patients aged 75 or over rose by 1.5 per cent, down from 2.2 per cent on the previous year.
This puts emergency admissions on course to meet the government's target of no more than 3 per cent growth over five years.
Health minister John Hutton praised local authorities for having improved their performance overall.
One hundred and twenty two out of 150 councils scored better than last year against 50 per cent or more of the indicators.
But he insisted there was still a lot more to be done. 'There is evidence that some national targets are not being met, and there is evidence that vulnerable people are still not receiving the type of care they have a right to expect.'
It was 'unacceptable' that one in 10 single adults and older people did not get a single room when they went to live permanently in residential or nursing homes, Mr Hutton said.
He also called for councils to take urgent action to improve their reviews of child protection cases: only one in six children on the child protection register had their cases reviewed when they should have been.
NHS Confederation policy manager Janice Miles said the increase in delayed discharges was an extra pressure which could potentially make this winter 'more of a problem'.
But she welcomed the indicators' evidence that older people were getting more of the support they needed to live independently. The new figures were one of the 'increasing signs that people in health and social services are trying to work more in partnership, 'said Ms Miles.
The positive trends in the social services performance indicators were also picked up by national patients' access team clinical director Kate Harmond.
'Health and social services are working more closely than I have ever seen in my 20 years in the NHS. Because the issue of funding is more relaxed and people know their budgets are robust for the next three years they are able to experiment.
People are thinking about outreach services in a way they have never done before.'
The Local Government Association was 'delighted' with the overall improvement in social services performance. Head of social affairs and health John Ransford said the areas of declining performance needed to be looked at.
But he denied the figures made another winter crisis more likely: 'We need to use all this information to make sure that knots are untied before the problems occur.'
Social Services Performance Assessment Framework Indicators. www.doh.gov.uk/paf