Social care pressures could see bed blocking crisis last another 5 years, says NHS chief

London should take control of its health and social care budget and have a health commissioner to help the mayor coordinate policy, the report argues.

"Bed blocking" that prevents the discharge of patients who no longer need acute hospital treatment could last for up to five more years because of building pressures on social care, the head of the NHS has told MPs.

The National Audit Office recently estimated that bed blocking costs the NHS £820m a year, with 1.15m bed days lost to delayed transfers of care in 2015 - up 31 per cent since 2013. This is against a backdrop of an 18 per cent increase in emergency admissions of over-65s between 2010-11 and 2014-15, and a 12 per cent rise for the whole population.

Appearing before the Public Accounts Committee, NHS chief executive Simon Stevens said reducing the number of beds occupied by people who are medically well enough to be discharged will be difficult because of growing strain on social care services.

"I don't think we can guarantee the number will be anything like zero over the next three, four or five years because there are real pressures building in social care and those pressure spill over into the NHS," he said.

Stevens added that no single approach has been effective in reducing delays.  

"We have looked at this pretty hard over the last 18 months and it has received an enormous amount of time in the NHS and [from] ministers," he told MPs.

"And every time you think you have come with an answer - 'if we could just sort this out, all will be well' - it just ain't like that."

In January, delayed discharges reacted the worst level on record, with NHS England saying that as of midnight on the last Thursday of the month, there were 5,799 patients who could not leave hospital because of a lack of appropriate care options. This was the highest monthly figure since trackings started in August 2010. 

The Local Government Association has previously warned that "chronic underfunding" and growing demand have left the care system in crisis and unless social care is put on a sustainable footing, the problem will only get worse. It has called for £700m in funding earmarked for the Better Care Fund by 2019-20 to be brought forward immediately. 

Jon Rouse, director-general of social care, local government and care partnerships at the Department of Health, told the committee that delays had grown longer in around six out of 10 local authorities over the last two years and there were "unacceptable variations of performance" across the country.

"The reality is that looking out over the next two or three years, there is likely to be a widening gap between the availability of social care and the need for adult social care," he said.

"That will show up in delayed discharges and extra pressure on hospitals."