GOOD news and bad news about the NHS is never symmetrical. Good news means everything is ticking along well, with no cause for alarm, but bad news is ever a clarion call of distress, with a need for urgent action.
The annual Scottish Intensive Care Audit has found that intensive care for the critically ill is generally “of a very high standard” across Scotland. That’s the good news. The bad news is that, in some parts of the country, patients are being discharged too early because of a shortage of intensive care beds. And if there is one board that does not need to hear any more bad news that is NHS Tayside.
Following earlier scandals involving the use of charitable donations to pay for essential services, and the departure of chief executive Lesley McLay after The Herald’s revelations, Tayside will be unhappy at making the headlines for all the wrong reasons once more.
But it has to face up to the finding that patients in its Intensive Care Unit at Ninewells Hospital in Dundee are three times more likely than the Scottish average to be discharged. That they are usually discharged to beds in other departments is something of mercy but one that is strained by their receiving, in the audit’s words, “a lower level of care”.
The problem is caused by there not being enough beds in the Intensive Care Unit. The report describes provision as “inadequate”. Here is an urgent task for NHS Tayside: make it adequate. It’s not an option. It’s a serious problem that has to be addressed.
How to go about that? Well, Dr Stephen Cole, the audit group chairman, has called on NHS boards with lower levels of critical care to reconsider their investment decisions. That is a good starting point. Funding, we know, is tight. It always will be. But a serious problem has been identified. Consequently, there has to be a serious attempt at finding a solution.
We should say that Tayside, which is also the centre of controversy over the centralisation of the most serious A&E admissions at Ninewells, is not the only board facing challenges. Forth Valley Royal Hospital had the worst record for delayed discharges, with 52 per cent held up for more than four hours, usually due to a lack of beds elsewhere in the hospital.
It’s the NHS. It’s never going to be perfect. But the whole point of these valuable audits is that they flag up problems that demand attention from the respective boards concerned. NHS Tayside became a significant embarrassment for previous Health Secretary Shona Robison. We’re sure that her successor, Jeane Freeman, will be keeping a particularly watchful eye on the situation there.
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