A GP leader has called for the roll-out of thousands of new community nurses to help drive down hospital bed blocking.
Dr Alasdair Forbes, deputy chair of the Royal College of GPs (ECGP) Scotland, said money saved by freeing up hospital beds could be used to directly employ thousands of new 'community auxiliary nurses' on the NHS "with proper pensions and rights" to help support elderly people to remain healthy and independent in their own homes for longer.
Read more: One in 13 hospital beds occupied by patient well enough to leave
Writing in the Herald, Dr Forbes said: "We tend to think of delayed discharges as a hospital problem. It is much more complicated than that. The roots of the delay lie in the community. Indeed, one of the main problems is that the current care workforce is fragmented, poorly rewarded and has high staff turnover.
"If we had locally co-ordinated care teams composed of carers, employed by the NHS, with proper pensions and rights, they could work to support hard pressed (and chronically short staffed) District Nurse and other community teams, and many admissions could be prevented.
Read more: Mystery over district nurse who 'left patient to die'
"Personally, I see them as ‘Community Auxiliary Nurses’, working not only to support the existing community nursing teams to deliver care at home, but also the wider primary health care team.
"Community nursing would also gain time for the increasingly complex patients that they currently see and care for. In essence, I regard this role to be akin to auxiliary nursing in hospitals."
The latest figures for NHS Scotland show that one in 13 hospital beds were occupied last year by a patient well enough to leave, but who could not be discharged because they were either waiting for a social care package or a care home place.
Dr Forbes also called for nursing homes to be supported to maintain "low tech" beds for frail elderly patients, since these are cheaper than acute hospital beds.
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Nearly 100 care homes have closed in Scotland in the past decade, and figures last week revealed that the number of available care home beds is the lowest since 2008.
Meanwhile, the number of available acute hospital beds has fallen 4% in five years, to 13,426.
Adam Stachura, Age Scotland’s Head of Policy and Communications said being stuck in hospital too long had a "serious impact" on older people's health.
He said: It is damaging to their health and is costing an absolute fortune which would be far better spent on social care. The daily cost of keeping someone in hospital unnecessarily is £234 a day, which is more expensive at times than staying at a five star hotel such as the Balmoral.
“The focus on shifting care away from the hospital and back to the community is the right one and is an effective solution to a complex challenge.
"Health and social care integration offers us a greater opportunity to explore different models of care such as community auxiliary nurses who could be effective in ensuring older people are able to live independently at home, with an enhanced quality of life for as long as possible.”
However, Theresa Fyffe, director of the Royal College of Nursing (RCN) Scotland said money would be better spent growing existing district nursing teams.
She said: "These teams already incorporate a range of nursing roles, including health care support workers and are an integral part primary care.
“But these teams are stretched, under pressure, and in desperate need of investment. Across Scotland more than seven percent of district nursing posts are vacant.
"Instead of looking at new roles, the focus must be on growing and developing existing district nursing teams to ensure that they have the resources needed to provide safe, high quality clinical care to people at home.
“The Scottish Government did commit to further investment for community nursing, and district nurses in particular, in the Primary Care Workforce plan, published earlier this year. We look forward to seeing the detail of that commitment in the coming weeks.”
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