Is hospital bed-blocking something that the NHS can solve?

WHEN I was chairman of the Devon branch of the Nursing Home Association in 2000, bed-blocking was rampant. I told the then Minister of Health, John Hutton, the way to stop it was to make local authorities pay the NHS the true cost of keeping patients in hospital when they were ready for discharge. Local authorities would soon find places for them. They do it in Sweden, so why not here?

NEVILLE PLATT, Poole, Dorset.

HOSPITAL bed-blocking is killing 8,000 people a year (Mail). one of the biggest reasons is patients waiting for their homes to be adapted before they can be discharged. a report by the london school of economics, commissioned in 2012 by the British Healthcare trades association, concluded that if investment in homecare aids and adaptations was at the heart of its adult social care reforms, it could yield a potential annual saving of £1,101 per person per year. in March last year, dr Mark

Spencer, then chairman of the NhS Alliance, highlighted the correlation between effective primary care (social and community care) and secondary care (hospitals) as part of the solution to an overstretched health service. The NhS Alliance also highlighted the huge savings (£2.5 billion) if patients could be discharged from hospital more quickly into a social care environment. however, herein lies the problem. Current procurement practice does not allow for cost efficiencies to be taken into account when buying or evaluating supply contracts and tenders if the beneficiary is another department or healthcare organisation other than that of the purchasing budget holder. This was illustrated a couple of years ago when Durham County Council chose not to award a regional community care contract to a local company. The reason given was that the county council felt the cost benefits to the NhS of being able to discharge patients back into the community three weeks earlier than previously wasn’t a consideration it could take into account, as the savings would not be reflected in its budget and to do so would contradict procurement rules. Once again, officialdom and bureaucracy is proven to have lethal consequences. Presently, public sector procurement strategy is placing much emphasis on ‘cost-effective procurement of goods and services’, when perhaps they should be looking at ‘cost-effective delivery of goods and services’. There is a small, but significant, difference between the two. If they focus on the latter, we could get a lot more healthcare for our taxes.

ANGUS LONG, Newcastle Upon Tyne.

ISN’T it time that we brought back convalescent homes for those who just need a little more nursing care before returning home?

SANDRA PARSONS, Keston, Kent.