THE effectiveness of steps taken to cut down bed-blocking in HampshireÕs hospitals will be tested for real from this week because of a new fining system which has been launched.

On Monday, the governmentÕs controversial delayed discharges fine system came into full operation which will see the county council fined £100 a day for every patient from the county, excluding Portsmouth and Southampton, who is in an acute hospital bed unnecessarily for social care reasons.

For the past three months the system has been operating Òin shadowÓ, meaning that the fines were only theoretical, giving social services the chance to work hard on implementing measures to tackle the problem. But from this week that has changed.

Delayed discharges, commonly known as bed-blocking, are caused when a person is fit to leave the hospital but is unable to do so because there is nowhere for them to go.

A large proportion of these are elderly residents who need to go into a care home or who need other forms of after-care but cannot be found a place due to a shortage of beds. This has forced social care and health workers to think of new solutions to tackle the problem.

Social services now has only two days to find somewhere suitable for the patient to go before Hampshire County Council receives the fine of £100 per patient per day.

Lynn Waight, from social services, told The Herald that one of the biggest problems was finding a suitable place for patients to be moved into.

ÒIt is not a question of finding somewhere that is not too costly - it is finding a place at all, because there are so few,Ó she said.

ÒIt is like the bus stop syndrome where the numbers waiting never seem to change but this is because every time a bus comes along, more people have joined the queue.

ÒIt is the same for us - new people are always joining the queue.Ó

She explained that the closure of nursing and residential care homes throughout the county has exacerbated the problems and forced the council to find new solutions.

Throughout the year the council has been working with the countyÕs primary care trusts and other organisations to come up with new ways to tackle the issue and has allocated an extra £3.5 million to pay for initiatives.

Solutions include schemes which provide people with intensive support on their return home from hospital, short-stay rehabilitation beds and rapid response services, which provide short-term intensive care preventing people from needing to go into hospital.

In addition a further £3.5 million has been made available by the county council to assist older people to live at home with the appropriate and intensive support they need.

This avoids the need to find a place in a care home, meaning that the patients can be moved from hospital much quicker, or even prevent them from being admitted at all.

Another major project to tackle the problem is the ÒENHANCEÓ project being implemented with health colleagues to create 500 new nursing home beds across the county on local authority and health sites from the autumn. Many of the sites for these beds have been identified and steps are being taken to get the beds in place as soon as possible.

Many of the measures taken by social services and health workers have had a huge impact on the problem of bed-blocking, with a snapshot view of the existing numbers, compared with last year, showing their progress.

This time last year there were 130 Hampshire patients ÒblockingÓ acute hospital care beds for social care reasons, while this week that figure was down to 32. Three months ago the figure was about 50.

Lynn Waight said: ÒWe have been working very hard on this. Historically it has got worse during the winter months, but it is a problem that we face all year round.Ó

If many of the new measures are successful then it is possible that the council, and tax payers, will not have to foot such a massive bill for the fines.

All local authorities have also been allocated grants to offset the cost of fines and in recognition of HampshireÕs particular problems - high proportion of older people, limited availability of care beds, recruitment problems and care bed prices - the county council received the largest grant in the country with £1.2 million.

It is expected that this cash will help towards the payment of the fines, but the potential fines which may be clocked up by the council could total an estimated £2.5 million each year.

This means that the council could have to pay around £1 million in fines from its own coffers.