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VIEWPOINT By Dr Andrew Whitehouse Consultant physician, West Midlands

Elderly people have to remain in hospital until social care is arranged

Bed-blocking is an ongoing problem for the health service, with elderly patients stuck in hospital waiting for their long-term care to be arranged.

In this week’s Scrubbing Up health column, Dr Andrew Whitehouse says the answer is to merge health and social services budgets – so elderly people get more streamlined care.

Why do we waste so much money treating our elderly so badly?

Every time I do my ward rounds I find, like other physicians, that roughly a third of my patients do not need to be in hospital.

We deal with the medical and rehabilitation needs of our elderly rather efficiently and we agree the way forward with the patient and her relatives.

When discharge is prescribed, we advise the social services department of any care needs the patient has.

It costs about £700 a day to keep a patient in hospital, and about £700 a week for a decent full-time nursing home placement

This may be for a home care visitor package to assist dressing or washing. It may be for residential or nursing home placement.

Then the wait begins.

The social services department has its own procedures for deciding on what, when and how to deliver, and of course we comply with these procedures diligently and promptly.

Indeed we begin to think about the plan for discharge at the point of admission.

But despite this cooperation long delays are routine; delays which dreadfully distress the elderly and their families for whom these may be precious last months or years, delays which result in hospital acquired infections and depression, and which mean the beds cannot be used for those who really should be in hospital.

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