Daily Insight: Utterly miserable situation

Patients face waits of up to nine months to be discharged from hospital, even though they are fit for discharge, an investigation by HSJ has found.

Figures obtained by HSJ show some patients at the trusts worst-hit by discharge delays have waited many months to leave hospital, due in large part to social care shortages.

The longest wait uncovered by the figures was one patient who waited more than nine months to be discharged from North Bristol trust.

The figures also indicated waits for home care were a big factor behind the delays.

The long waits have been described by Age UK as an “utterly miserable situation”. The King’s Fund has said these patients often have highly complex needs, are elderly and frail, have mental health conditions or learning disabilities, or among the growing numbers of working age people whose conditions are becoming more complex.

The trusts involved said they were investing in pathways to speed up discharges, while one is launching a new home care agency to meet the extra demand.

Barclay’s war on waste

Steve Barclay, who brought with him a reputation as a fiscal hawk when he became health and social care secretary in July, has fired the first shot in his war on NHS waste.

A missive sent out to national finance chiefs – and also briefed to The Telegraph – told NHS England, the Care Quality Commission and other central agencies to slash 20 per cent from their spending on management consultants, professional services and contingent labour.

Mr Barclay sees cutting costs by a fifth as a bare minimum and believes savings could go further – often as high as 80 per cent – and “may wish to increase the ambition”, according to the letter.

A source from the Department of Health and Social Care characterised the move as shock therapy to wean arm’s-length bodies off expensive consultants. “If you just salami slice you never get the cultural change,” they said.

The letter is thought to be the first move in a DHSC efficiency review started by Mr Barclay. It is supported by Lord Agnew, a former Treasury minister who has previously said civil servants had been “infantilised” by relying on external consultancy.

Of course, whether Mr Barclay will be able to implement the remaining parts of the review depends on who becomes prime minister on Monday.