NHS discharges patients into hotels to ease bed blocking and A&E crisis

NHS hospitals are discharging patients into hotels to ease the demand for hospital beds.

At least three NHS trusts in the south west of England are using “care hotels” to move patients who no longer need urgent treatment but require social care to free up beds for incoming patients.

Discharged patients facing an average wait in the hotels of around a month before they can receive the care they require in their own homes, or find accommodation in a care home.

Age UK told i that the strategy “underlines just how severe the crisis in social care has become”.

In hospitals across England is believed to have between 100 and 200 patients taking up bed space, despite being ready for discharge due to a social care package not being available.

In Devon, the NHS has booked rooms to accommodate up to 40 patients at the Leonardo hotel in Plymouth.

NHS Devon had originally booked 30 beds in the hotel, but following a deal with its counterpart in Cornwall, it extended the block booking by 10 to take patients from across the county border.

A spokeswoman for NHS Devon said: “Care hotels are just one of many positive measures health and care partners have put in place to reduce pressure on busy health services this winter.

“They do not contain hospital patients and are used to provide social care for people who are medically fit and do not require hospital care but do need additional living support after a stay in hospital or to prevent them from needing to be admitted.”

As well as sharing the hospital in Plymouth with NHS Devon, the NHS Cornwall and Isles of Scilly Integrated Care Board (CIOS ICB) is in talks to set up a facility of its own.

Cornwall’s only major hospital, in Truro, has wait times for patients of up to 12 hours. The county’s health and care system is operating at critical incident level, after “acute pressure” had “escalated our operational level”, health bosses said.
The care hotels in Cornwall and Devon, which will be run by private care providers, are expected to be in use until the end of March.

Prime Minister Rishi Sunak pledges to ease the pressure on the NHS as he outlines his five point plan (Photo: Stefan Rousseau/Pool via Reuters)
Rishi Sunak pledged to ease the pressure on the NHS with a five-point plan (Photo: Stefan Rousseau/Reuters)

NHS hospitals in Bristol and surrounding areas have also booked hotel accommodation for up to 30 patients until the end of March.

A spokesman for the Bristol, North Somerset and South Gloucestershire Integrated Care Board said: “Local health and care services are under significant pressure and this temporary care facility delivered at a local hotel will help us to improve the flow of patients through our hospitals by ensuring more people can be discharged as soon as they are medically fit to leave hospital.

“Nobody should have to stay in hospital longer than necessary and this facility will ensure more people can be discharged promptly. It will also improve the flow of patients through our hospitals while helping to address ambulance handover delays.”

The Bristol hotel is being run by private homecare company Abicare.

Since the beginning of the Covid-19 pandemic Abicare has been commissioned by regional NHS organizations to run 20 care hotels.

While other NHS trusts around the UK are considering similar moves, it is understood the South West’s greater proportion of elderly residents has led to a particularly acute shortage in social care provision.

According to Age UK, “an excess bed in the NHS” costs around of £2,500 a week. The cost of a care hotel is just under £1,000 per resident each week, while a residential care home costs around £520 a week.

Last summer, Care England criticized an Abicare care hotel in Norfolk, which cost taxpayers £15,555 per care recipient during the Covid-19 pandemic.

Norfolk and Waveney Clinical Commissioning Group undertook a three-month pilot scheme in early 2022, to alleviate pressure on local NHS hospitals.

It sent 36 patients to a care hotel for an average of 16 weeks each in what Care England said represented “incredible mismanagement” of £500,000 of public funds and was “wholly unacceptable”.

Abicare responded by claiming the cost represented a “significant cost saving” for the NHS.

Anne-Marie Perry, managing director at Abicare, said: “Keeping the 36 patients who filled one of our care hotels at one point in hospital for the same length of time would have cost the NHS £1.6m or £44,800 per patient. The cost of £15,555 per care recipient was then not only a significant cost saving, it also released 36 hospital beds and freed up hospital staff to care for other patients.”

Minutes from an NHS Devon board meeting show it has set aside a total of £9.85m to pay for “enhancing discharge capacity from hospitals” until the end of March, with schemes across the system including care hotels, additional community-based rehabilitation care and support and measures to help people who have complex dementia leave hospital safely.

Caroline Abrahams, charity director at Age UK, said: “The fact that this policy is even under discussion underlines just how severe the crisis in social care has become.

“Hotels are not in an appropriate place to provide high-quality care for older people in need of support to recover after a spell in hospital.

“If the only other option is keeping someone in hospital, it may indeed be the lesser of the two evils, but it’s a sad indictment of successive failure to invest in a stable, functioning social care system capable of providing the right help at the right time.

“If we want to solve the problem of hospital discharge once and for all, we need reform not more sticking plaster solutions.”

Outlining his five promises on which he said his premiership should be judged upon, Prime Minister Rishi Sunak acknowledged the pressure on the NHS after his spokesman was criticized for suggesting the health system was not in crisis in a briefing on Tuesday.

Mr Sunak said: “I know there are challenges in A&E. People are understandably anxious when they see ambulances queuing outside hospitals.”

The PM also promised more hospital bed capacity as well as funding for social care to help discharge patients who are ready to leave.

NHS England was contacted for comment.

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