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Rapid hospital discharges are leaving patients with more complex social care needs when they get home

Urgent warning from social care directors that councils can’t cope with rising spending as NHS discharge unwell people

Holly Bancroft
Social Affairs Correspondent
Tuesday 16 July 2024 11:20 BST
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A wave of rapid hospital discharges is leaving vulnerable patients with more complex social care needs when they get home, council bosses have warned.

Local councils are being forced to overspend to cope with people being more unwell when discharged to the community.

The number of people requiring multiple visits from two or more care workers has increased by 7.5 per cent in a year, with 49,000 patients now needing this type of care.

The average number of homecare hours that councils provide per person has also risen from 697 in 2022, to 750 in 2024.

Council spending in this period on home care was up by just over a quarter (27 per cent), and around a quarter of directors reported increases or significant increases in the size of packages of council-funded care from community-based settings in 2023 last year.

90 per cent of directors either have no confidence or are only partially confident their budgets will be sufficient to fully meet their statutory duties in provision of social care in 2024/25
90 per cent of directors either have no confidence or are only partially confident their budgets will be sufficient to fully meet their statutory duties in provision of social care in 2024/25 (PA)

The Association of Directors of Adult Social Services (Adass) spring survey got responses from 95 per cent of the 153 English councils with social care responsibilities.

President of Adass Melanie Williams said the report showed the future of adult social care was “unsustainable and worrying”, adding: “We can’t keep doing more of the same.”

The membership organisation for those working in adult social care in England warned that investment must shift from a focus on freeing up hospital beds to better funding for social care.

The report, published on Tuesday, found: “Too often higher numbers of people discharged from hospital result in more people waiting at home for social care, or discharged to care homes that they never leave – many of whom will inevitably deteriorate, leading to higher needs in the longer run or even hospital readmission.”

Adass described a financial situation “as bad as it has been in recent history” when it comes to adult social care budgets, with a £586 million overspend in 2023/24 and “an increasing reliance on one-off reserves to prop up budgets”.

Its survey showed that 90 per cent of directors either have no confidence or are only partially confident their budgets will be sufficient to fully meet their statutory duties in provision of social care in 2024/25.

The pressure on councils to provide more hours of complex care and support means people needing low-level and early support at home “are at risk of missing out or their needs escalating”, Adass warned.

Skills for Care, the strategic workforce development and planning body for adult social care in England, is due to launch its new workforce strategy for adult social care on Thursday.

It has previously said the strategy will identify the workforce needs over the next 15 years and produce a plan for ensuring the sector has enough of the right people with the right skills.

A spokesperson for the Department of Health and Social Care said: “We are determined to tackle head-on the significant challenges social care faces.

“We will undertake a deep-rooted programme of reform to create a National Care Service and make sure everyone gets the care they need.”

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