A lack of care home places keeps some patients in hospital

The government has given councils across the UK extra money to reduce the bed-blocking problem but will take it back in the form of fines paid to the NHS if they fail.

Kent County Council has said it intends to take the gamble of spending its �1.2m grant in advance to provide alternatives to acute hospital care rather than saving it to pay any fines it may incur.

Bed-blocking is when vulnerable elderly people are kept in hospital because of a shortage of beds available in care homes.

We are expecting that by investing in advance it won't be more than the amount of fines we would have to pay Oliver Mills, Kent County Council

The council is thought to be one of the first in the country to make a deal with the NHS before the government's initiative comes into force in January under the Community Care (delayed discharges) Bill.

The alternative was for social services to pay �100 each day to the local hospitals trust for each patient who was fit to be discharged but remained in an acute bed.

Oliver Mills, director of operations for social services, said it had not been easy reaching agreement between all parties but it had been worth it to avoid a "bureaucratic nightmare".

'Taking a risk'

Mr Mills said: "We decided it made much more sense for us to spend the money we would have spent on fines on developing a range of services to help people not to have to go into hospital.

"We are taking a risk essentially.

"We are expecting that by investing in advance it won't be more than the amount of fines we would have to pay, therefore no money would actually have to be spent.

"What we are trying to do is prevent the need for people to go into hospital if they don't need to in an emergency.

'Step-down beds'

"Often that means the need also to provide extra services to help people come out of hospital."

The council plans to create a number of "step-down beds" in residential care homes where people can convalesce for two or three weeks before deciding whether to return home or enter a care home.

Mr Mills said the council was also working with voluntary organisations to extend schemes giving elderly people extra support when they first went back to their own homes from hospital.

He denied the problem had been exacerbated by closures of council-run care homes.

The authority will receive a further �2.4m from the government next year to continue the schemes.