Bed block in state hospitals has seen the premier turn to the federal government asking for increased support.
On Friday Premier Jeremy Rockliff wrote to federal health minister Mark Butler and disability minister Bill Shorten, saying discharge delays of long-stay disability and aged care patients were causing bed block in Tasmanian hospitals.
Mr Rockliff said there were 29 aged care patients and 17 disability patients ready to be discharged, but waits on aged care accommodation and NDIS packages were causing delays.
The Premier asked the Commonwealth to pay for transitional care pathways while the governments found more suitable long-term options.
"Acute beds are not the right environment for people medically fit for discharge," he said.
"Patients should be discharged as soon as they are medically cleared from acute hospital beds, and this simply isn't happening due to blockages out of the control of our state system.
"We are committed to a patient-centred approach to providing the right care, in the right place, at the right time, and hospitals are not the right place for people who are clinically ready to leave."
One Care chief executive Peter Williams said there were always aged care vacancies across the state, but the challenge in moving patients from acute to residential settings came down to standards of care.
Mr Williams said the transitional sub-acute space served an important link between aged care and the acute sectors, but there needed to be clarity on responsibilities.
"Aged care services can absolutely support the acute sector to reduce their bed block," he said.
"But in order for that to happen there must be greater collaboration between the acute sector and aged care in terms of our legislative requirements and what we operate under, rather than just push people out and expect that they don't bounce back.
"The reality here is if they discharged someone inappropriately because we can't care for them, the only choice we have as an aged care provider is to put them in an ambulance and send them straight back, and that's just creating the same problem."
National Disability Service state chairperson Mark Jessop said not all people with a disability required an NDIS plan, and it could take three months for an assessment to be made.
"The difficulty with the hospital is they can't start that assessment until [patients are] medically stable, but by the time they're medically stable the hospital wants to get them out because they shouldn't be there," he said.
Mr Jessop said the state also had to commit to transitional pathways, with transitional housing often the major impediment.
"The major barriers for providers are accommodation, clinical planning, funding certainty and ongoing duty of care if funding is reduced," he said.
"The need to 'hold' accommodation waiting for discharge is not something providers can do - even if we had surplus accommodation. The state could solve this by offering a discharging client community housing for the first 12 months to support their transition.
"Getting people out of hospital is therapeutically a good idea, it's ethically a good idea and it's a greater community benefit ... the whole disability sector absolutely supports getting people out of hospital as soon as it's practical."
Independent health consultant John Kirwan said the situation highlighted the Commonwealth and state intersection not functioning as it could.
"You should not be in an acute hospital unless you need acute hospital care. It is as simple as that," he said.
"The intersection between a state system under pressure because it's full, with a Commonwealth system that is probably not as responsive as it should be in some areas ... that's what they need to sharpen their pencils at."
"If they can't improve them ... they should probably look at some interim sub-acute model."
NDIS and government services minister Bill Shorten said he would not make any promises overnight, but his government was deliberately tackling the hard issues.
"Frankly, since I've become the Minister for the NIDS I've discovered the problem is worse than I imagined, even from opposition," he said.
"And the reality is, even if we can reduce waiting times or processing times in Tasmania, there is insufficient housing to fix the issue."
Mark Butler was contacted but did not provide a response before the deadline.
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