Controversial plans from NHS Ayrshire & Arran to charge a health partnership for the cost of delayed discharges in hospitals have been batted back by authority chiefs.

The move followed the release of a report which reveals delayed discharge is currently costing NHS Ayrshire and Arran almost £5 million.

A delayed discharge occurs when a patient cannot leave hospital because the necessary care, support or accommodation is not available for them.

According to a report presented to the North Ayrshire Integration Joint Board (IJB), which oversees the work of the area's health and social care partnership (HSCP). acute services in Ayrshire and Arran are projecting additional costs because of unfunded beds remaining open at Crosshouse and Ayr hospitals.

There has been a total overspend of £4.7m on delayed discharge so far this year.

As a result, the health board’s director of finance has approached the three IJBs in Ayrshire - one for each local authority in the health board area - asking them to make a payment for delayed discharges.

 

The approach attracted a robust response from Caroline Cameron, chief officer of the North Ayrshire HSCP, at a meeting of the area's IJB last week.

Ms Cameron said: “We have never paid for delayed discharges bed days previously. Our delays are over a number of sights and settings, so the request is centred around patients in acute hospitals.

"Currently, as of October 9, there were five patients who would come under that criteria.

“There is currently no established agreed mechanism to undertake that payment. The integration scheme review has commenced and is under way, and that is the place to have those discussions moving forward.

“We have put significant investment into our care at home services, and our ability to do that would be further constrained if we were to agree to this.

“My advice is not to consider this approach at this time, and we would like that to be considered as part of a wider review of the integration scheme rather than as a short-term request.”

The IJB's members were told that while there have been significant efforts made, and some areas of improving performance and patient outcomes, there remain areas where progress has been challenging.

A previous report presented to the IJB on unscheduled care provided information on additional acute hospital bed capacity which had been created at Crosshouse and Ayr hospitals as a response to the pandemic.

This additional bed capacity was, however, unfunded and it was estimated that cost of those beds for 2022-23 would be £9m.

After five months of the 2023-24 financial year, the unfunded beds have cost £4.7m.

A "focused programme of work", with a view to closing the unfunded beds, linked to activity around improving urgent and unscheduled care performance, has been in place since 2022.

Whilst a number of unfunded beds have been closed across Ayr and Crosshouse hospitals, there remain unfunded beds open going into winter.

The report says that both sites have had to place additional patients in unfunded beds in ward areas and other areas of the hospital.

This also impacts on wider community services including the use of capacity in downstream beds and support required from HSCP community teams.

The total number of people delayed in their discharge from hospital has risen from 187 at the end of July 2022 to 251 at the end of July 2023 with a peak of 261 reached at the end of December 2022.

A significant number of patients are discharged without delay, currently sitting at 94.4 per cent of patients.

Across Ayrshire and Arran, this has reduced from the 95 per cent reported in June 14.

The proportion of patients discharged without delay has remained fairly constant, between 94 per cent and 95 per cent, since May of last year.