Andrew Vine: Failure of social safety net traps elderly on NHS wards

A KEY cause of the NHS winter crisis was pretty much summed up by the plight of an elderly friend who found herself stuck in a hospital bed because there was nowhere for her to go.

Social care is the latest emergency to hit the NHS.

A broken ankle requiring surgery is a very serious injury for somebody of 79, who suddenly found her cherished independence compromised – and her pride deeply wounded by knowing she was a so-called ‘bed-blocker’.

Managing at home by herself was out of the question. She needed help with bathing and dressing, and standing up to cook meals was beyond her for now.

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Add to that a fear of falling and being unable to help herself, and the need for a couple of weeks’ care until she regained enough mobility to return home – which she dearly wanted – was clear.

Except no council-run or funded care home place was available. She couldn’t afford to go private, and so she was stuck in hospital. This lasted for a week, and every time I visited, it was apparent that it was hampering her recovery.

She fretted constantly at taking up a bed that should have gone to somebody in greater need, feeling guilty at being what she saw as a burden on a system that had helped her.

And faultlessly kind though the nursing staff were, they were so rushed off their feet that they had too little time to get her out of bed and moving to start improving her mobility.

One of those staff told me that she was not the only elderly patient stuck on the ward because of a shortage of care home places.

Just how upsetting this all was, coming on top of an injury that had badly shaken her, was apparent when she wept at being told that a place had become available which meant she could leave hospital.

Happily, she’s now on the mend and will soon be back at home.

Individual crises like this, not just here in Yorkshire but across the country, make it apparent that the NHS’s problems cannot be fixed in isolation, but demand to be addressed in the wider context of care.

Last week’s stark warning by accident and emergency doctors that patients are dying prematurely because there are insufficient hospital beds makes this winter’s health crisis one the bleakest Britain has faced.

The queues of seriously ill people lying on trolleys in corridors for hours, or of makeshift wards set up to accommodate them, speak not only of a service struggling to cope but cries out for a long-overdue rethink on the part social care must play.

It is intolerable that somebody rushed into hospital by ambulance cannot find a place on a ward because beds are occupied by people who no longer need them.

The social care crisis mirrors that of the NHS, and is aggravating the problems that hospitals face.

As the population ages, and increasing numbers of elderly patients without support networks are admitted for treatment, it is they who are blocking beds because there is a lack of care provision when they are well enough to be discharged.

The Government needs to address this urgently if the NHS is to cope, and make it a national priority.

There has been a woeful lack of joined-up thinking by successive governments over how to dovetail hospital care with what happens to older people in need of support during their recuperation

Fragmented families and working lives busier than ever before can mean that children or grandchildren are unable to offer the help that might once have been taken for granted.

The state has failed to step in and create a safety net for vulnerable, frail and often frightened older people who cannot cope without help.

A health and care system that on the one hand does its very best to make elderly patients well, yet on the other fails to help them along the road to recovery, is deeply flawed.

Last year, the Government engaged in a disgraceful exercise in buck-passing over social care, shoving responsibility onto local authorities by allowing them to introduce a council tax rise to pay for it.

That was only ever going to produce patchy results, because wealthy areas would raise much more than poor ones, and completely missed the point that caring for the elderly coming out of hospitals must be addressed on a countrywide basis.

Adding responsibility for social care to Health Secretary Jeremy Hunt’s brief in last week’s reshuffle was a long-overdue acknowledgement that it cannot be regarded in isolation nor left to already hard-pressed councils.

As with every problem that the health system faces, it will all come down to money. But the NHS winter crisis cannot be solved by funding that service alone. If lack of social care provision is not tackled as well, the queues of patients on trolleys in hospital corridors will only grow longer.