PATIENTS with long-term health problems are waiting months for rehabilitation services to help them live independently.
Despite the Scottish Government's flagship policy to look after the elderly in their homes, an investigation by The Herald has revealed delays as long as 36 weeks before people receive a visit from staff trained to help patients look after themselves.
Experts have described the delays as unacceptable. By the time some receive a visit from a rehabilitation professional, such as a physiotherapist, it could be too late for best effect.
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Dr Jason Long, chairman of the College of Emergency Medicine in Scotland and an A&E consultant, said: "Not being able to access rehab or not having reasonable home care can be the reason why people have to be admitted to hospital. Any wait can be a problem."
In Glasgow, the wait for a visit from the rehabilitation service is four to nine weeks. In Renfrewshire the maximum wait to see a physiotherapist this year ran to 36 weeks.
However, there is wide variation across Scotland, with some health boards claiming rehabilitation teams can go in as soon as they are needed and others saying they do not have information on how long patients are waiting.
Dr Long said: "There should be a basic standard throughout the country for patients accessing rehabilitation services."
Looking after more people in their own home is crucial to the Scottish Government's policy for caring for the growing elderly population.
The Herald's campaign NHS Time for Action is calling for a review of capacity in the NHS and social care to ensure there are the resources to cope. This newspaper used Freedom of Information legislation to find out how long patients referred to community rehabilitation teams wait for a first visit.
Among the health boards that could answer the question, maximum waits running to several weeks were common. Borders, Fife, Glasgow, Renfrewshire, West Dunbartonshire, East Lothian, Midlothian and Dundee all recorded maximum waits of more than two months for first visits from rehabilitation staff this year.
In West Dunbartonshire, patients deemed high priority had to wait between three days and six weeks.
Kenryck Lloyd-Jones, policy officer for the Chartered Society of Physiotherapists in Scotland, said: "Waiting months for community physiotherapy services is unacceptable.
"While there may be individual circumstances which require a delay, long waits for community physiotherapy can be counter-productive for NHS services. It can put unnecessary pressure on A&Es, if patients deteriorate while waiting and need hospital treatment.
"This particularly applies to people with long-term conditions in cardiac and respiratory care."
Professor Paul Knight, president of the British Geriatrics Society and a community geriatrician at Glasgow Royal Infirmary, said: "Timely access to assessment and treatment in the community can make the difference between staying at home and being admitted to hospital.
"You often only have a limited window of opportunity for these things [to make a difference] in older people who are living with frailty. To make an intervention worthwhile and effective you need to reach the individual as early as you can make it."
A spokeswoman for NHS Greater Glasgow and Clyde said: "Community Rehabilitation Teams are a relatively new service designed to enable more people to be cared for in the community and as they have been succeeding we have experienced demand pressures in some areas we are working to address with additional capacity. Urgent and priority patients are being seen within days. We recognise we need to work harder with our local Community Health Partnerships and Community Health and Care Partnerships to reduce waiting times for non-urgent appointments and one measure is the recruitment of four whole-time equivalent physiotherapists in Renfrewshire."
There has been a 3 per cent increase in the number of allied health professionals including physiotherapists working for the Scottish NHS since 2011 and waiting times targets specifically for patients with musculoskeletal problems are being introduced in 2016.
Scottish Health Secretary Alex Neil recently pledged £5 million to upgrade local health services to help patients stay at home.
l As part of The Herald's NHS: Time for Action campaign we are looking to talk to people about their experiences of care in the community. If you or a relative receives care services at home, please tell us what you think. We would also like to hear from those who work with elderly people in their own homes . Contact firstname.lastname@example.org.