Shortage of homecare workers leaves patients stuck in hospitals

Almost one in four patients were unable to be discharged from hospital as they were waiting for home care, The Guardian has revealed.

The lack of homecare workers has been described as "perilous" by the deputy director of research at Nuffield Trust, Sarah Scobie, and has led to people having to stay in hospital for weeks longer than they need to which in turn is driving up waiting lists for hospital beds. Fifteen per cent of homecare jobs are currently vacant as homecare workers are quitting because of low pay.

It is estimated that in April 2022 one in six patients remained in hospital because of a delayed discharge and the discharge of patients who had been in hospital for more than three weeks was delayed by an average of a fortnight. A first of those unable to be discharged were waiting for short-term rehabilitation and 15% were waiting for a bed in a care home.

Bleak outlook for home care

And it's not just the immediate situation that looks concerning. Homecare organisations have reported that its even harder to recruit staff now than at the same time last year which was after 18 months of the pandemic.

Director of the Homecare Association, Dr Jane Townson, said: “People are ending up in hospital for malnutrition and dehydration, problems which, even if you supported people a little bit at home, would stop."

“More providers are having to turn down work than usual and some are having to hand back people because they can’t do it.”

‍Councils across England have reported that the humber of hours of home care they’ve been unable to deliver because of the lack of capacity rose to 2.2m in the spring, a massive leap from less than 290,000 hours for the comparable period the previous year.

Negative effect of delayed hospital release

The Nuffield Trust think tank warned that if people stay in hospital longer, the data shows they get more ill which creates even more pressure on social care.

“Delayed discharges are a lose-lose situation, creating congestion in hospitals and distress for patients, increasing infection risk and muscle deterioration from being stuck in a hospital bed,” said Sarah Scobie.

“An effective homecare sector would reduce these unwanted delays, but it faces an uphill battle.”

Government announcement on social care fund

In September 2023, the government announced a £500m workforce development fund to ‘level up opportunities for the social care workforce’ but representatives from the social care community have said it doesn’t go far enough.

Sarah Scobie described the £500m as “a drop in the ocean when set against the perilous situation with care outside hospitals.” 

Dr Townson added “Without long-term investment in homecare, this short-term funding, though welcome, will be just another sticking plaster that won’t address underlying problems.”

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