Comment: Delayed discharge penalties are already giving impetus to joint working

Published: 08/01/2004, Volume II4, No. 5886 Page 17

The NHS plan promised an end to 'widespread bed-blocking' by 2004. Although the last NHS chief executive's report showed that total delayed discharges had fallen by 21 per cent to 4,267 in the 12 months to September 2003, clearly there is still progress to be made.

However, as our news focus special shows (pages 12-15), the introduction this month of bedblocking fines for local authorities has already had an impact. Arrangements vary - some have ruled out fines entirely, some have set up arbitration systems - but there is a common view that the Community Care (Delayed Discharges etc) Act has helped give impetus to the quiet revolution of joint working between health and social services in many, if not all, parts of the country.

As government adviser Derek Wanless pointed out at last year's NHS Confederation Welsh conference, although Sweden is widely seen to have made a success of the same system, it was unpopular with all sides in the beginning. However, the Department of Health's aim to limit delayed discharges to 2,000-2,500 by the end of 2005 suggests that a sizeable rump will remain for some time. Addressing that may require a less quiet revolution, and a greater role for private care home providers.