Concerns raised about discontinuing enhanced hospital discharge support

Hospital trust leaders remain concerned about the fragility of the social care sector and local government funding as the government publishes its winter plan for social care, setting out how it will support the sector over the coming months.

NHS Providers said that NHS services and local government care are totally interdependent, they cannot succeed without each other.

Amongst its concern was that funding to continue enhanced hospital discharge support seems unlikely to continue after March 2022. Without central funding, this risks reversing the many benefits of this discharge model for patients and the health and care system.

This approach means people who are clinically ready and no longer need to be in hospital are supported to return to their place of residence where possible. Long-term social care needs assessments take place at a point of optimum recovery so that individuals have the long-term support they need.

The government has made £478 million available to continue hospital discharge programmes through the winter until March 2022. Funding will be provided for up to four weeks of post-discharge recovery and support services, for new and additional care needs during the second half of the year, for care delivered on or before 31 March 2022. The programme will not fund care delivered after 31 March 2022.

Covid-19 deaths in care homes

The first social care winter plan was published in 2020 outlining how the sector would overcome the challenges it faced.

The additional funding provided for the enhanced discharge measures, and the general speed of collaboration between the NHS and adult social care in removing barriers to safe and timely discharge (for those who are clinically fit to be discharged) was generally viewed as being a success.

The review found that Covid-19 accounted for around 40% of all deaths of care home residents between April and June 2020 in the first wave of the pandemic and this reduced reduced to 26% of all care home resident deaths between September 2020 and February 2021 in the second wave.

The report concluded that: “Whilst cause and effect is difficult to unpick, the evidence strongly suggests that the actions taken since the beginning of the pandemic, including those outlined in the winter plan, have had a significant impact in reducing risk.”

What are the challenges in social care this winter?

Winter challenges highlighted in the report include an increasingly stretched adult social care workforce, with recruitment continuing to be difficult in many places. This is in addition to the infection risk posed by the possibility of a new Covid-19 variant of concern, as well as other respiratory viruses, despite the improved infection prevention and control practice across the sector since the pandemic began

To support the health and social care system to meet these challenges, the government is:

• Providing £388.3 million in further funding to support infection prevention and control, testing and vaccination uptake in adult social care settings; this is in addition to a further £478 million to continue enhanced hospital discharge support until March 2022
• Providing eligible frontline social care workers and carers with free flu vaccination this season, ensuring that pharmacists are able to vaccinate staff and recipients of care in care homes, and that frontline social care workers can continue booking their first and second dose of the Covid-19 vaccine through the National Booking Service
• Continuing to provide free PPE for Covid-19 needs to the adult social care sector until the end of March 2022, with sufficient stock to cope throughout winter. Regular asymptomatic Covid-19 testing will be maintained, with availability of more intense testing regimes for higher-risk settings. UK Health Security Agency (UKHSA) health protection teams (HPTs) are prepared to arrange multi-virus testing when required for respiratory viruses in care homes
• Continuing to support care providers to make best use of technology to support remote monitoring, enable secure online communications, and enable people within care homes to remain connected with friends and families.

Miriam Deakin, director of policy and strategy at NHS Providers, said: “It is good to see that the plan recognises the many challenges the social care sector has faced over the past 18 months and, crucially, the challenges to come in what we know will be a very difficult winter.

“While previously announced funding allocations, such as the Workforce recruitment and retention fund to help recruit staff and retain the existing workforce are welcome, we recognise that this funding will not address the long-term staffing issues facing the sector which requires sustainable support. And while a winter plan is welcome, the sector, and those needing its support, also deserve the certainty that comes with a long-term, sustainable plan for its future.”