“We recently announced £14 billion more for health and social care. Part of that money will go to a new discharge fund to speed the discharge of people from hospital back into their homes and communities. That money is already making a difference on the ground. We can see the numbers of people unnecessarily in hospitals are already reducing, easing the burdens in our accident and emergency departments.”
During Prime Minister’s Questions on 8 February, Prime Minister Rishi Sunak made a series of claims about hospital discharge funding. He said part of £14 billion in new health and social care funding will go to a new discharge fund aimed at speeding up hospital discharges in England. He added that this money was “already making a difference” and that “we can see the numbers of people unnecessarily in hospitals are already reducing, easing the burdens in our accident and emergency departments”.
Over the past two weeks we’ve tried to fact check these claims, but this has been difficult because Number 10 has declined to explain what specific information Mr Sunak was referring to or provide any evidence to back up what he said. The Department of Health and Social Care (DHSC) has given us details of funding set aside to speed up discharge, but has not clarified what Mr Sunak’s claims were based on.
This is disappointing. Politicians making serious claims in public debate should be prepared to explain their claims and support them with evidence. Number 10 has also failed to back up two other claims from Mr Sunak in recent weeks, on A&E patient flow and Labour party funding.
The figures discussed in this piece relate to the NHS in England, for which the UK Government is responsible.
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Number 10 hasn’t explained what Mr Sunak was specifically referring to when he spoke about a “new discharge fund”, but over the past six months the government has announced a total of £750 million in funding aimed at speeding up the discharge of people from hospitals into their homes and communities
This includes a £500 million adult social care discharge fund, announced in September 2022, intended to “support discharge from hospital into the community and bolster the social care workforce, to free up beds for patients who need them”.
Of this, £300 million was given to integrated care boards (ICBs) and £200 million to local councils across December 2022 and January 2023.
ICBs are bodies which are responsible for aspects of local health service planning, including budget allocation, previously done by Clinical Commissioning Groups.
In addition to this £500 million fund, on 9 January the government announced a further £200 million fund, “to enable the NHS to immediately buy up beds in the community to safely discharge thousands of patients from hospital”, which was to be made available “immediately”, as well as £50 million in capital funding “to upgrade and expand hospitals including new ambulance hubs and facilities for patients about to be discharged”.
As Mr Sunak was talking about a new discharge fund which was already having an impact, it seems likely he may have been referencing some or all of the funding outlined above. But if so, it’s not correct to say that this money comes from the total £14.1 billion in funding for health and social care announced by the Chancellor in the Autumn Statement.
The DHSC told us the money allocated to the discharge fund is for use this winter, whereas the £14.1 billion in health and social care funding is for the 2023/24 and 2024/25 financial years.
In the Autumn Statement, the government announced £600 million of new grant funding in 2023/24 and £1 billion in 2024/25 to help get people out of hospital and into care settings. However, this money is not for the current winter period, and is being distributed through the Better Care Fund.
Is the funding already having an impact?
Mr Sunak’s claim that the new discharge fund was “already making a difference on the ground” echoes a DHSC press release on 9 January, which claimed that the first tranche of funding “reached the frontline in December and is already helping discharge people more quickly”.
While both these statements suggest the funding has already made some difference, we’ve not seen any specific data on what impact the money has had, and routinely-published publicly available data shows delayed discharges peaked around the time the DHSC press release was issued.
When we asked about the statement issued on 9 January, the DHSC told us “early data” suggests that local systems are discharging more people now than prior to the release of the funding in December 2022, but that it was continuing to work to better understand the impact of discharge funding.
It also said that the impact of the fund will be measured using a number of metrics, some of which are already included in existing NHS data, but it did not provide us with any specific data related to this.In the absence of any further explanation from Number 10, we asked health policy experts at the Nuffield Trust about Mr Sunak’s claim that the fund was “already making a difference”.
A spokesperson told us that, as yet, there is little information available publicly about how the fund has been used, and that it’s not currently possible to say delayed discharges have improved or that the money has directly driven any change.
Once again, we don’t know what data Mr Sunak was referring to when he claimed “the numbers of people unnecessarily in hospitals are already reducing”, or whether he was directly linking this to the discharge fund, because Number 10 hasn’t offered any explanation of his claim.
We asked the Health Foundation what it thought this claim might relate to, and it pointed us to daily discharge data published by NHS England, which shows that at the time Mr Sunak spoke, the number of patients remaining in hospital who no longer met the criteria to reside (ie, who were fit for discharge) had fallen slightly from a peak in early January, but remained above the average for the whole winter period.
In the week between 23 and 29 January (which was the most recent week of data available when Mr Sunak spoke on 8 February), an average of 13,983 patients in England remained in hospital each day who were fit for discharge.
This figure had reduced slightly from the peak in early January, when the highest average seen in any seven-day period was 14,327 between 5 and 11 January. But it was higher than the average number for the previous week (13,566), and the average across the whole winter period so far (13,496). And as the chart above shows, the number of patients who are fit for discharge but remain in hospital fell then rose again in January, making any broader trend hard to spot.
Since Mr Sunak spoke, two further weeks of data have been released which show the seven-day average increasing to just above 14,000, before falling again to a level roughly in line with the whole winter average.
Mr Sunak also claimed that reducing the number of patients unnecessarily in hospitals was “easing the burdens in our accident and emergency departments”. Again, it’s not clear what data Mr Sunak was relying on here, but A&E waiting times and trolley waits did improve in January, compared with December 2022, though this data was published after Mr Sunak’s PMQs comments.
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Image courtesy of Number 10