This year, urgent activity in English NHS hospitals has reportedly hit a record high. Officially reported 'delayed transfers of care' (inpatients medically fit to leave, but awaiting community health and care services) have also peaked. These figures routinely underestimate the real number of people in beds whose needs no longer require the full facilities of the general hospital.
Hospitals are routinely declaring 'Red' and 'Black' status alerts and their executives are coming under increasing pressure from politicians, regulators, and NHS England over declining performance against the four hour standard for emergency department assessment and treatment (a target almost unique to the NHS). Emergency readmissions to hospital within 30 days are running at around 15 per cent for patients aged 65 or over.
All this has happened against a background of: an ageing population; the increasing medical and social complexity of acute hospital patients; drastic cuts in funding to social care services, which might otherwise support people to remain at home or leave hospital sooner; and inadequate capacity and responsiveness in intermediate care services outside of the hospital.