Fireworks are expected in the council chamber next week over the issue of so-called “bed blocking” at Shropshire hospitals.

At Shirehall, the Liberal Democrats are scenting blood, convinced that the budget set aside by the ruling Tories for services for older people is totally inadequate.

But is this really the case? Are elderly patients unable to leave hospital because the council is either unwilling or unable to pay for their after-care?

It is not as straightforward as some would have us believe.

Last week, for example, no one was stuck in a county hospital waiting to be discharged because the county council was unable to fund the care they might need at home or in a nursing/residential setting.

Yet we hear frequent reports of elderly Shropshire patients being “trapped” in hospitals for months waiting to be discharged.

So if this is the case, is it right to lay most of the blame at the door of county social services? There are in fact various reasons why someone might have to wait a lot longer on a ward than expected.

Ruth Houghton, the county council’s area manager for countywide services, says it could be to do with choice – where a patient or family member is not happy with the location of nursing or residential home, or the patient is a ‘self-funder’ and not relying on the authority to fund their care.

Delays can also be caused because the patient’s condition has changed rapidly and they are not medically fit for discharge; the patient is waiting for a place in a care home to become available; they are awaiting housing or adaptations to their own home; there has been an unexpected change in their assessed need; or the patient is in fact the responsibility of another authority.

“We always try to move people out of hospital as quickly as possible,” insists Mrs Houghton, who strongly denies that the council is in less hurry to see patients discharged from Shropshire’s four community hospitals than from the Royal Shrewsbury.

The law says that a local authority must make a payment to the healthcare provider when an NHS patient’s discharge from hospital is delayed because the necessary community services have not been put in place. It covers the acute sector, such as the Royal Shrewsbury and Telford’s Princess Royal, but not the smaller community hospitals.

The council maintains it is a priority to help get patients discharged as soon as possible, whichever hospital they might be in – but there have been claims that up to 150 people at any one time might be unable to secure care packages because of a funding shortfall, and some of these will have to remain in a hospital bed.

Each week, a co-ordination panel meets to consider funding requests. Last week, for example, it agreed funding for two patients from the Royal Shrewsbury and one from the Princess Royal, and also agreed funding for five patients at community hospitals.

Seven were classed as ‘self-funding’ – following a financial assessment they were found to have capital of more than £21,000 and were not the responsibility of county social services; four were the responsibility of other local authorities; and three had funding agreed but were not discharged because of a dispute over choice of care home.

Some patients will choose care homes that are in, or close to, their local community so that family and friends can visit easily. Occasionally this can mean waiting for a bed in a specific home to become vacant.

What is very clear is that the council puts a lot of effort into preventing hospital admissions, and works closely with the NHS to prevent delayed discharges.

I called in at Louise House at Meole Brace, Shrewsbury, which was opened by the council last year and where the the Trust runs a chronic obstructive pulmonary disease clinic and exercise class which offers support to older people to help manage their condition, which helps prevent them having to be admitted to hospital.

People are also referred to the clinic on hospital discharge for a course which lasts about six weeks and combines both exercise and education. Similar clinics are run at 11 different venues across Shropshire.

Louise House is now also the base for the council’s highly regarded START initiative (Short Term, Re-ablement and Assessment Team), which makes sure a patient ready to be discharged home will have the necessary practical help and support to help them regain their independence. Avoiding delayed discharge is a key priority.

I also called into the see the strangely named Joint Interface Team at Copthorne, a joint council and NHS venture which works closely with the Royal Shrewsbury to ensure timely and appropriate discharges. The 20-strong team includes social workers, benefit workers and discharge liaison nurses.

A close eye on bed blocking is being kept by the council’s watchdog health overview and scrutiny panel, which received a report a fortnight ago that showed delayed discharge rates in Shropshire were below the national average.

Liam McKervey, assistant director, health and social care, says delayed discharges are a feature of health- and social-care systems. They have and will always exist but the aim is to keep them to the minimum.

To me – and I have no political axe to grind – it would seem the council is doing all it can to ensure this is the case and that patients are not being kept on hospital wards because of a massive hole in the social-care budget. But something tells me the politicians are unlikely to let this issue rest . . .

By Dave Morris