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Alarm at surge in number of patients blocking NHS beds

THE number of patients stuck in hospital beds for weeks because of care shortages in the community has rocketed in Scotland.

Despite the relatively mild winter, hospitals appear to find it harder to discharge patients, with new figures showing the number of patients blocking beds for six weeks or more has risen by 165%.

Health Secretary Alex Neil said part of the problem was care homes being closed amid concerns about the quality of the service they were providing.

Waiting for a care home place was the most common reason for delay, but patients were also held up queuing for social care assessments and for funding to be in place for care packages.

The Herald is running a campaign calling for a review of capacity in the NHS and care sectors as part of a plan to help them cope with the growing elderly population.

A raft of data on Scottish hospitals also shows other parts of the NHS struggling to cope with the number of patients.

The figures, released yesterday, revealed more than 11,000 people waiting beyond 12 weeks for a new hospital appointment - up from 5678 at the end of December 2012 and 5579 at the end of 2011.

Waiting times in accident and emergency departments, while better than during last winter's crisis, are still among the worst recorded with 93.5% of patients dealt with within four hours.

Some health boards are still not treating patients within 12 weeks of doctors agreeing their care plan despite this guarantee being enshrined in law.

The figures were published on the same day the Scottish Parliament voted through the Public Bodies Bill, which is intended to merge NHS and council care services and improve both bed blocking and the rising tide of hospital admissions, which is stretching services.

However, experts say more action will be needed to address the pressures on the care sector and hospitals.

Councillor Peter Johnston, health spokesman for the Convention of Scottish Local Authorities, said there were several reasons why delayed discharges were higher than expected: "First, a growing number of care homes cannot be used as discharge destinations because of problems with the quality of the care they are providing... Second, care at home services continue to be stretched by increasing demand and diminishing resources. We therefore need to look at long-term funding challenges in respect of supporting an ageing population."

Mr Johnston said resources needed to be moved from hospitals into the community to better support the frail in their own homes.

The figures show 909 patients delayed in hospital when they were well enough to leave in January, the highest figure recorded since 2010. Some 151 patients had been delayed by more than six weeks, compared to 57 in January last year, a 165% surge.

Neil Findlay, Scottish Labour's health spokesman, said: "The increase in the number of delayed discharges shows exactly why we need a wholesale review of the NHS. The fact that patients aren't able to move on to nursing home places or because they are awaiting community care assessments shows that both health and social care services are struggling to cope with the increasing pressures they are facing because of the challenges of our ageing population."

The Royal College of Nursing also

expressed concern about the new NHS performance data. Ellen Hudson, associate director of RCN Scotland, said: "One thing we all know is that demand is going up as people live longer, often with a range of complicated conditions. So while health boards are putting right past cuts and are trying to recruit nurses to try to meet this demand, pressure is still growing because health boards are trying to recruit to posts but there just aren't enough appropriately qualified nurses available. This is evident from the fact that vacancy rates are currently standing at 2.5%."

Mr Neil said there were some delayed discharge hotspots, such as Aberdeen. He added: "There have been 57 care homes which have had admissions frozen or closed down quite rightly to improve quality. That has taken 800 beds out of the system. That obviously is having an impact on discharge figures."

He said the Scottish Govern-ment was working with local authorities to address the issue.

Mr Neil defended A&E waiting times, saying they were better than similar performance figures in England and Northern Ireland. He also said the NHS was doing well with outpatient waiting times but shortages of some specialists, in fields such as cancer, had created challenges in some parts of the country.

Meanwhile, Dr Neil Dewhurst, the outgoing president of the Royal College of Physicians of Edinburgh has warned that doctors and nurses are being placed under "almost intolerable pressure" because of cuts in the number to hospital beds, growing admissions and staff shortages.

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