Social services departments are warning of a looming crisis in the NHS this winter because a lack of local government resources is creating a mounting problem with delayed discharges - a prediction supported from within the NHS.
A survey by the Association of Directors of Social Services and Local Government Association found that the 150 social services departments in England are overspent by an estimated£183m.
Much of the overspend has been on services for elderly people and children.
That is in addition to the£1bn councils are being forced to find in order to plug the shortfall in central government allocated funds for social care, says the ADSS and LGA.
ADSS president Moira Gibb acknowledged that the government put in additional money last year for 'winter pressures', so that elderly people were not forced to stay in hospital unnecessarily, but said the government had yet to meet the rising level of demand from the community and increasing nursing and residential home costs.
'The growing shortages of places for older people in residential and nursing homes is leading to spiralling increases in costs, ' she said.
John Ransford, head of social affairs, health and housing at the LGA, has been reluctant in the past to be seen as scaremongering over bed-blocking, but is now less guarded: 'It is getting worse, ' he said. 'It is really serious. What we are concerned about is the effect on delayed discharges. That is going to cause problems. Shortterm money provides some relief, but what do you do next year?
'We agree this is about allyear capacity planning. More money has gone into the NHS through the NHS plan, but not to social services.'
His concerns were echoed by Sonia Mills, chief executive of Swindon and Marlborough trust, which was had severe problems with delayed discharge.
At one point the trust had as many as 80 people stuck in hospital unnecessarily because of the financial problems encountered by Wiltshire social services department, which could not pay for care packages.
Wiltshire health authority agreed last December to transfer an extra£664,000 to the county council in recognition of its financial problems. This allowed 54 patients, who had been waiting three months for discharge, to be transferred to residential and nursing homes.
But the trust has continued to face difficulties throughout the summer and Ms Mills predicts even more problems to come.
'It affects us every day because of the lack of availability of funds, ' she told HSJ. 'It means where we have to admit people they start their care on a trolley on a ward while we find a bed.We have also had to cancel operations through the year because beds were not available.'
At the moment, she says, they have about 30 elderly people in hospital who do not need to be there but cannot be moved on. The primary care goup bought in 30 beds in nursing homes last winter to ease the crisis then. They are still full today.