PATIENTS admitted to hospital wards need faster decisions and treatment, top doctors have warned.
Two leading clinicians said delays waiting for social care services - such as a care home places - only accounted for half of the hold-ups that block beds and leave hospitals overcrowded.
Dr Martin McKechnie, chairman of the College of Emergency Medicine Scotland, and Professor Derek Bell, president of the Royal College of Physicians of Edinburgh, are both pressing for hospitals themselves to examine the pace at which they deal with patients.
Their comments follow revelations that more than 3,300 patients had to be treated in the wrong hospital department for their condition because of bed shortages this summer.
Dr McKechnie said the growing number of elderly patients with complex needs admitted to hospitals was a key reason for these capacity issues. However, while there has been much emphasis on the need to improve community services to prevent admissions and ensure pensioners can leave hospital when they are well enough to go home, he believes there is also a need to look at the culture on the wards.
Dr McKechnie said: "To some, all the problems in the hospital are caused by social care difficulties. I am not sure that is entirely fair. I think there are things in hospital that could be done quicker.
"If you look at what happens in the emergency department and acute medicine units, the pace is high and the intensity is high and the concentration of activity and decisions is high. If you look downstream in the wards, that pace is not the same."
The College of Emergency Medicine wrote to all health boards highlighting the issue. The letter referred to patients dying because A&Es were overcrowded with people queueing for space on wards, and said the solution lies within hospitals as well as in social care.
Professor Bell said roughly 50 per cent of patients who have an elongated hospital stay do so because of "what needs to happen more efficiently with the hospital sector itself."
He said the NHS needed to be more sophisticated about the right speed to move patients through different parts of the hospital system.
The Herald's campaign NHS: Time for Action is seeking a review of capacity in health and social care to ensure the resources are in the right place at the right time to cope with the growing elderly population.
A Scottish Government spokesman said it was investing £3.5 million in "ground-breaking models to improve the flow of patients through the whole of the health system, with the aim of freeing up beds and reducing the amount of time that patients spend unnecessarily in hospital".
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