Half a million lost bed days are symptom of poor care integration, says disability charity

‘in many areas of Scotland, the integration of health and social care is happening in name only’

The loss of over half a million bed days in Scotland’s hospitals over the past year is a symptom of the failure to integrate health and social care, according to the disability charity Leonard Cheshire in Scotland.

Figures published by ISD Scotland show that a total of 542,204 bed days in 2019/20 were occupied by people delayed in their discharge from Scotland’s hospitals.

This represents a 4% rise in the number of bed days lost due to delayed discharges between 2018/19 and 2019/20. A daily average of 1,481 beds were occupied by people delayed in their discharge over the past year.

A delayed discharge occurs when a person, clinically ready for discharge, cannot leave hospital because the necessary care, support or accommodation required is not readily accessible or funding is not available, for example to purchase a care home place.

The main reasons for patients being delayed in their discharge in 2019/20 were awaiting completion of care arrangements (35%), awaiting place availability (23%) and awaiting community care assessment (17%).

ISD Scotland estimates that in 2017/18 alone, the cost of delayed discharges in NHS Scotland was £122 million – with an estimated average bed day cost of £248.

Reacting to the figures, Leonard Cheshire in Scotland’s Director Stuart Robertson said: “These figures demonstrate that in many areas of Scotland, the integration of health and social care is happening in name only.

“More than half a million bed days have been lost over the past year in Scotland’s hospitals due to delayed discharges and it’s time the Scottish Government finally tackle this issue. Over half of patients who experienced a delayed discharge have been impacted by a lack of care arrangements, availability and assessments.

“Delayed discharges are costing the Scottish Government over a hundred million pounds every year and are badly letting down disabled people and those receiving health and social care.

“Investment on the frontline is urgently required if we are to end delayed discharges and create a person-centred health and social care system that truly meets the needs of the Scottish people.”

Briggs: blame Scottish Government for delayed discharge crisis

Extent of the impact social care crisis is having on delayed discharge in Lothian revealed

Latest figures for delayed discharge, from the Delayed Discharge NHS Scotland (Annual Release) show the extent of the challenge facing Integration Joint Boards in Lothian. Continue reading Briggs: blame Scottish Government for delayed discharge crisis

Briggs: Critical Care delayed discharges at the Western General remain highest in Scotland

This week’s Audit of Critical Care in Scotland report has revealed that the critical care unit at the Western General Hospital in Edinburgh has significantly higher delayed discharge rates than the rest of Scotland. Continue reading Briggs: Critical Care delayed discharges at the Western General remain highest in Scotland

Health and social care: An improving picture but more needs to be done, says EIJB Chair

The length of time people are waiting for care assessments in the Capital has fallen by almost 50% under the Edinburgh Integration Joint Board (EIJB), (writes its Chair, Councillor Ricky Henderson). Continue reading Health and social care: An improving picture but more needs to be done, says EIJB Chair

Delayed discharges up: Greens urge social care staff boost

Scottish Ministers are being urged by the Scottish Greens to “fast-track action” on social care staffing, as new figures show a further rise in patients stuck in hospital – the vast majority of them waiting for social care. [1]

Continue reading Delayed discharges up: Greens urge social care staff boost

Delayed Discharges: Green MSP Concerned At Lothian Levels

Alison Johnstone, Health spokesperson for the Scottish Greens and MSP for Lothian, has expressed concern at the high level of delayed discharges – people stuck in hospital beds awaiting social care. Continue reading Delayed Discharges: Green MSP Concerned At Lothian Levels

NHS Lothian moves to treat waiting time issues

NHS Lothian is creating an innovative partnership with Scottish Government to help boost performance and improve patient care across the health board. The partnership, which will also work with the Edinburgh Integrated Board, is creating a Whole System Dynamic Review and Targeted Analysis at the Royal Infirmary of Edinburgh to help tackle delayed discharge and waiting times.

The move comes as health boards across Scotland begin to suffer extreme winter pressures. Earlier this week NHS Lothian recorded the worst performance for A&E waiting time targets since the publication of weekly figures began almost three years ago.

The collapse in its figures follows last month’s admission by NHS Lothian that acute hospitals had been under-reporting waiting times. The latest weekly figures show  just 77.3% of patients were dealt with within the four-hour target.

In an attempt to address this the new partnership, which will also work with the Edinburgh Integrated Board, is creating a Whole System Dynamic Review and Targeted Analysis, at the Royal Infirmary of Edinburgh, to help tackle delayed discharge and waiting times.

Jim Crombie, Deputy Chief Executive, NHS Lothian, said: “Like a number of other health boards, NHS Lothian is experiencing significant winter pressures across our whole healthcare system. There are a number of contributing factors, including the increasing complexity of cases presenting at emergency departments and significant numbers of delayed discharges.

“This new way of working will allow us to zoom in on processes and procedures, not just in the Emergency Department, but across the acute care system to help improve patient flow through our hospitals.”

The group will provide enhanced support and resources to analyse systems across the board in a bid to improve the patient journey through the hospital.

A set of Whole System Indicators will be created to help boost and measure performance and attainment.

Mr Crombie also reminded patients of the need to ensure they seek the right care, in the right place, at the right time for them. He added: “It could be that self care at home or a consultation with a pharmacist or GP is best when you are feeling under the weather or for many common illnesses.

“As the winter chills bite, so do the numbers of slips, trips and falls. But it is important to remember that these kind of injuries can be treated at the Minor Injuries Unit at the Western General Hospital, rather than a lifesaving emergency department.”

 

£4.5 million boost to tackle pressure on city’s health and social care

A £4.5m fund to help reduce both waiting times for assessments and delayed discharges in the capital has been approved by the Edinburgh Integration Joint Board (EIJB). The one-off allocation will support the work of the newly established assessment and review board to help alleviate the most urgent pressures and will also improve business processes.

Continue reading £4.5 million boost to tackle pressure on city’s health and social care