Hospitals have been told to consider taking legal action against patients who refuse to leave beds when they no longer require treatment.
More than one in seven beds in English hospitals are currently occupied by patients who are deemed medically fit to leave, official NHS data show, with around 12,000 stuck on January 9.
NHS England guidance, sent to trusts just before Christmas, said if a patient “with mental capacity” is refusing to leave because they do not accept the follow-on care offered the trust should follow the local discharge policy, which could involve legal action.
The guidance, seen by the HSJ, says “the process may include seeking an order for possession of the hospital bed under Civil Procedure Rules Part 55”.
If a trust seeks such an order the case would be heard in county court and, if the judge rules in its favour, the patient would be served notice to vacate the bed.
Sparsity of social care
Patient groups warn the guidance appears to lay blame with the patients, rather than “sparsity” of social care currently available, for the bed-blocking issue.
Hundreds of care homes have closed to new admissions in recent weeks due to the spread of the omicron variant, limiting social care options for patients fit to leave hospital.
Helen Wildbore, Director of the Relatives & Residents Association (R&RA), said the guidance will be “upsetting” for those “already in such a vulnerable situation”.
“Not only are older people facing an anxious wait for appropriate care and support, but now to hear the message that they are the problem,” she said.
“R&RA and many others have been warning for months that care shortages are putting people’s safety and wellbeing at risk and that this will have a knock-on impact on the NHS. Now it is at crisis point but older, vulnerable people are not to blame for that.”
Step-down care offered to patients who are fit to leave hospital may not always be suitable, as it’s located miles away from loved ones or doesn’t meet the patients’ needs and wants, Ms Wildbore said.
People in England in critical care hospital beds
The guidance comes after a record 12,986 people had to wait more than 12 hours in A&E departments in England in December from a decision to admit to actually being admitted, NHS figures show.
Meanwhile, nearly one in four patients arriving at hospitals in England by ambulance last week waited at least 30 minutes to be handed over to A&E departments.
Some 18,307 delays of half an hour or more were recorded across all hospital trusts in the seven days to January 9, NHS England data shows, 23 per cent of all arrivals by ambulance.
An NHS spokesperson said: “These powers already exist and are utilised in a very small number of cases, and only when all other options to support a person’s discharge have been unsuccessful.”