This week a major incident was declared at the Royal Bolton Hospital's A&E department. Saiqa Chaudhari examines the reasons for the department being under so much pressure.

THE dust had barely cleared in the Royal Bolton Hospital's accident and emergency department - where patients faced waiting times of more than 11 hours - before politicians began to cite reasons for the problems.

Bolton South East MP Yasmin Qureshi was among the first, saying cuts to social care were to blame.

But now Bolton Council has hit back, saying demand for social care is being met.

About 18 to 20 per cent of patients in hospital need local authority support to be arranged before they can be discharged — and the council says it is coping well with this workload.

The council provides home care for people who have left hospital, as well as intermediate beds to look after patients between their hospital stays and returning home.

Adrian Crook, the council's assistant director of adult services, said: “There is demand on the health economy but it is working — there have been no discharge delays because of social care for those who need it.

“We were informed that a major incident was going to be declared and we increased the number of social workers in the hospital to help with the discharge.

“We intervene in the discharge procedure early on, and will start to put a support package in place.”

Delays in discharge could be caused because the care support package may involve the input of other agencies, he says.

He said: “Sometimes the support includes medical equipment, or two carers, and we are told at the last minute.

"That can take time to put together, but we, the Clinical Commissioning Group, the trust and the local authority — are working well together.”

Among those who claim social care is to blame, however, is campaigner Gwen Parr, who fought to keep beds open at Westhoughon care home Winifred Kettle.

A revamp of adult social care last spring led to the loss of all intermediate beds at Winifred Kettle Community Care Centre and the closure of Firwood House, another care home in Crompton Way.

Mrs Parr said: “There are beds lying empty at Winifred Kettle and the hospital has difficulty freeing up the beds.”

The number of intermediate care beds in Bolton has been cut from 80 to 62 in the last year.

But council officers say care in the community has not been affected by the loss, adding that money has been invested in care for people at home, which is the preferred option for many patients.

A joint investment of £616,000 with NHS Bolton was ploughed into home-based healthcare for recovering hospital patients, which is now, for the first time in Bolton, provided 24 hours-a-day.

And £2 million was invested in Laburnum Lodge, another home that has intermediate beds.

The latest figures show that 230 people are being cared for in their own home compared to 148 at the same time last year, and more people are being treated using intermediate beds – meaning resources are being used efficiently and more options are available for patients' needs.

Margaret Asquith, the council's director of adult and children's services, said: “The feedback we are getting from patients is very good — and the outcomes for them are good, which is very important.

“Readmissions to hospital are low — Age UK is monitoring and reassuring those who do not meet the criteria for a social care package.

“The CCG, the trust and the local authority are integrating services and putting together a discharge team so the needs of patients can be assessed by one team, rather than them being referred on to different agencies, to make the process easier.

“We are at the very early stages of integrating services but it is already making a difference.”