There will be “avoidable deaths” and “dramatic effects” on vulnerable people in Sheffield unless health services change, warns a council report.
People are more likely to be admitted to hospital than in other cities and more likely to stay for longer than they need to.
The council is forecasting increasing pressures on budgets with a £61m funding gap by 2023, says Greg Fell, director of public health.
The council and the Clinical Commissioning Group (CCG) are working closely to help people stay out of hospital and recover quickly but social care in the community will be crucial.
The council will concentrate on preventing ill health in the first place, supporting people to stay within communities and reducing inequalities. Mr Fell warns that doing nothing is not an option.
In a report, he says: “Without social care, hospital discharge will suffer dramatically, beds will become unavailable for those who need them and NHS costs will rise.
“Business as usual is not a realistic option. Doing nothing also carries financial risks.
“An option would be for the council to focus solely on statutory responsibilities, removing discretionary support in order to address the immediate financial challenge.
“This would have dramatic effects on people, leaving its most vulnerable residents unsupported. The impact on partner, NHS organisations would rapidly lead to financial failure and then inevitably, to very poor outcomes for individuals, which would include avoidable deaths.
“It would also lead to subsequent failure for the council, as our budgets became more and more focused on dealing with more and more acute demand for services.”
The report says even people who need help with housing and benefit advice or have mild illnesses often end up admitted to hospital because community services are “ill equipped” to meet their needs, particularly in emergencies.
“Once in hospital, people stay too long. We know Sheffield needs to improve around delayed transfers of care by better supporting the earliest possible discharge.
“Long stays lead to a higher risk of functional decline for individuals, leave services being overwhelmed and are financially unsustainable.
“In short, our current system means too many people need to go into hospital, and stays are too long.”
Inequality is also an issue. “This problem is seen more frequently in deprived communities, where inequitable access to preventative, primary and community care services results in a higher rate of emergency hospital admissions.”
Officers say good work is already happening with a range of programmes to help people stay out of hospital and recover quickly if they are admitted.
The initial focus will be on frail people, those with special educational needs and mental health. A commissioning plan will shift investment from acute services to preventative services.
The report will go before Cabinet this week and can be viewed here