Hospitals can be bad for your health, says Holyrood committee

Hospitals can have a negative impact upon patient’s health, according to a Scottish Parliament Committee.

The Health and Sport Committee’s report, looking ahead to the Scottish Government’s budget 2020-21, highlights the significant extra costs of keeping patients in hospital compared to intermediate care, care homes or home care.

The report demonstrates that keeping patients in hospital when they are ready to be discharged is damaging to their health. However, too often patients are left in hospital as there are not adequate resources to move them to a more suitable setting in the community. This comes at significant cost to the public purse.

Evidence provided by the Scottish Government has revealed the hugely detrimental impact of a patient staying in hospital when they are fit to leave. For some older people, 3 weeks in a hospital bed can be the equivalent of 30 years of ageing.

The latest statistics have shown that across Scotland’s health boards the overall figure for delayed patient discharges has risen by 6% in the last year from 493,614 to 521,215.

In order to tackle this issue the Committee recommends an increased focus is given on reducing unscheduled care and admissions at hospitals and ensuring the needs of patients are met in other areas of the NHS.

The report recommends a review of communication strategies around alternatives to GP Referrals and says GPs must have the confidence to offer alternative healthcare routes to the patient.

Lewis Macdonald MSP, Convener of the Health and Sport Committee, said: “It is completely unacceptable that so many people in Scotland are stuck in hospital when they are fit to leave due to the lack of adequate facilities in the community to discharge them.

“It’s clear this is having a profoundly detrimental impact on people’s health and wellbeing. The situation is made even more tragic by the fact it impacts mainly upon the older and more vulnerable in our society.  It is also a drain on scarce resources.

“The Committee believes more must be done to communicate that hospitals are not always the best and most suitable option. This will reduce unnecessary calls to the GP, out of hours service and A&E, and help reduce costs and pressures on the acute service.

“We know health boards are under great financial pressure but solutions must be found as, in the long run, any investment in social care can help ease the financial burden on the NHS and more importantly help boost people’s health.”

The Committee report also:

• asks the Scottish Government to consider if intermediate care when caring for vulnerable people could and should be implemented across the country.
• calls for priority to be given to housing adaptations – helping move patients when possible from hospital to person-centred accommodation.
• seeks clarity from the Scottish Government on whether those health boards who received brokerage in the last financial year will have to repay the amount received.
• states that the transformation of services across Scotland’s NHS required can only be achieved through a focused campaign of engagement with members of the public.

Just last week, Scottish Community Alliance director Angus Hardie highlighted just this issue in the organisation’s Local People Leading newsletter.

Angus Hardie said: “Everyone hopes that they’ll live to a ripe old age. And as one gets older, the detail of what that might actually mean becomes a matter of increasing personal interest and concern.

“Hospitals have an unfortunate term – bed-blocking – for patients who, although medically fit enough to be discharged, lack the required support at home and are therefore forced to remain in hospital. Aside from the well-documented health risks of hanging around hospitals, the emotional distress and sense of despair these patients experience must be awful.

“Last week, new figures from NHS Lothian revealed the extent of the problem – unnecessary days in hospital cost £20m last year. That’s £20m spent making people miserable. Notwithstanding the worrying trend of increasing numbers of elderly people being so lonely and isolated within their own communities, it’s equally obvious that our current crop of social care providers is hopelessly ill-equipped to do anything about it.

“But for a fraction of that money, health boards could be strengthening the informal networks of support that underpin all communities, reconnecting the lives of these elderly folk with all that’s around them. Creating happier lives while spending less, in communities that can care for their own. What’s stopping us?”

Food for thought, surely  … ?

 

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davepickering

Edinburgh reporter and photographer