Sturgeon: Care home beds plan to ease hospital logjam

Further details of the plan - which echoes moves also underway in England - will be outlined in a statement by Health Secretary Humza Yousaf to the Scottish Parliament tomorrow.

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However, speaking during a briefing on the NHS crisis at St Andrews House in Edinburgh, the First Minister said the initiative would help to "free up capacity" in hospitals by transferring people temporarily into care homes while social care packages are arranged.

She said: "I can confirm that we will be providing immediate extra funding to health and social care partnerships to support the booking of additional care home beds for patients to be discharged to while their care packages are being finalised.

"That will benefit patients, I think it's important to note that first and foremost, but it will also free up much-needed capacity in hospitals."

Guidance will also be issued to health boards by the Scottish Government this week advising them to consider prioritising "critical and lifesaving care" where necessary, which could include relocating staff or pausing elective activity. 

NHS Borders already suspended all planned operations at the end of last week as a result of bed shortages due to patients with flu, Covid and norovirus, while several health boards paused their elective orthopaedic work in December until the end of January to free up beds. 

Ms Sturgeon said: "A letter of guidance will issue to boards this week making clear that they can and should take steps to prioritise and protect critical and lifesaving care if that is deemed necessary...these steps could include, for example, delivering a different model of care for a short period to prioritise critical and life saving care, opening or procuring additional capacity, and relocating staff to areas of greatest pressure."

She said there were "no easy solutions" to the current crisis, but that GP practices will also be encouraged to open at weekends in an effort to reduce attendances at A&E - a policy already adopted in NHS Lanarkshire - with additional NHS 24 call handers also being recruited to help manage medical problems remotely amid a surge in flu and Covid cases.

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It comes after doctors warned that conditions are "unsafe" as a result of bed shortages which are logjamming A&E departments and leaving ambulances stranded outside, waiting hours to offload patients.

The First Minister said hospitals were "almost completely full" with more than 95 per cent of beds occupied as of Wednesday last week.

That compares to 87% occupancy rates in January 2020 - pre-pandemic - and the 85% threshold recommended for safe care and infection control. 

Ms Sturgeon also said the health service was facing "unprecedented" strain from surges in Covid, flu and other respiratory viruses. 

Rate of flu in Scotland during December were the highest in 12 years, with one in 25 infected with Covid by the end of the month. 

Ms Sturgeon said there were currently 1,200 people in hospital with Covid, and that 1000 people with flu had been admitted to hospital in each of the last two weeks. 

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The NHS is no longer routinely testing staff or patients for Covid, but patients with symptoms will be tested and isolated if they are positive. 

Hospitals are expected to keep patients with infectious respiratory infections in wards separate from other patients, but this reduces the availability of beds for admission. 

Ms Sturgeon said it was important to acknowledge that the NHS "was under pressure before Covid struck us", but that the pandemic has worsened the situation. 

She said: "Changing demographics and ever increasing expectations of what healthcare advances can deliver, which of course in themselves are positive developments, were posing challenges for the NHS and necessitating reforms to care pathways.

"That said, Covid, and I think we know and understand it, represented a significant shock to the system and its ongoing impact together with associated backlogs, coupled with extraordinary levels of other illnesses this winter, is creating pressure that is truly unprecedented."

Doctors and medical leaders have stressed that the current issues for the NHS are long-standing, however, with the Royal College of Emergency Medicine saying that NHS Scotland needed around 1000 extra beds even before the pandemic to meet demand. 

They have also repeatedly stressed than 'exit block' is the biggest problem facing A&E departments, rather than attendances - which still remain below pre-pandemic averages. 

Before Covid, the four-hour A&E waiting times target - which stipulates that 95% of people attending A&E should be seen, treated and subsequently discharged, admitted or transferred within four hours - had not been met since August 2017. 

In December, compliance fell below 60% for the first time with a record 1,925 people spending over 12 hours in emergency departments in the week to Christmas. 

This also has a knock-on effect for ambulance handovers, with one in 10 patients brought to hospital by ambulance in the final week of December waiting over three hours to be offloaded into A&E. 

Ms Sturgeon said ambulance crews were "preventing hundreds of admissions a week" to A&E by treating and discharging more than half of patients at the scene. 

"That's better for patients, but it also reduces pressure on hospitals," she said. 

Before the pandemic, more than 60% of people who called the ambulance service would be taken to hospital. 

However, those who are admitted to hospital now also tend to "tend to be sicker with more complex needs", said Ms Sturgeon, which means they will spend longer in hospital.