BED-BLOCKING in Gwent hospitals seriously hampers attempts to maintain emergency and elective services.
And an Assembly target to reduce by 15 per cent in a year the number of patients classified as bed-blockers presents "a huge challenge", warns Gwent Healthcare Trust's head of performance Alan Davies.
Gwent is a priority for the Assembly's new Change Agent Teams (CATs), set up to improve admission and discharge of patients between community and hospital settings. But even with this help, trust bosses are sceptical.
Achieving the 15 per cent cut in each category of bed-blocking or delayed transfer of care - social care, health care and patient/choice - will mean reducing by 93 the number in Gwent from the end of March, from 268 to 175.
But two-thirds must come from the category of social care, provided by local authorities - often short of money to fund care home placements and care packages. Mr Davies said a recent review left the Assembly with "a better understanding of our situation, and has also shown it that much of what the trust does is good practice, and many problems are beyond the trust's control".
But he foresees "substantial problems ahead", with much work to be done by the trust and Gwent's five Local Health Boards and local authorities.
Gwent has more than a quarter of Wales' bed-blockers. Twenty of the 268 at the end of March were in acute hospital beds, with more than 200 in community hospitals.
But the situation may worsen with the likely decommissioning of 18 beds funded for last winter, and with Gwent already having fewer hospital beds per 1,000 of its population than anywhere else in Wales, every bed is extra valuable.
Trust chief executive Martin Turner said without the bed-blocking problem, "it could be argued that 100 people could be moved out of acute settings more quickly, and get appropriate rehabilitation and physiotherapy more quickly. And although we have sorted out a lot of health-related issues for these patients, they do not necessarily leave hospital as a result."
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