The number of days that patients who have been delayed from leaving hospital because of no appropriate place to go to has risen to 7,829 for July 2021, the latest month statistics are available for.
This is an increase of 2,004 from 5,825 delays throughout June and triple the number of bed days occupied from delayed discharge at the start of the Covid-19 pandemic when 2,531 delays occurred.
At the start of the Covid-19 pandemic SNP Ministers made the decision to move hospital patients into care homes, to free up hospital space for dealing with the Covid-19 pandemic. It later emerged that patients being moved from hospitals to care homes where not tested for Covid-19 leading to higher rates of Covid-19 deaths in care homes than anywhere else in Scotland.
The level of delayed discharge in NHS Lothian has now returned to pre- pandemic levels with the number of bed days in hospital for delayed discharge being 11 higher than March 2020, 7,278, when hospital patients where moved to care homes.
Edinburgh and the Lothians were in the process of recovering from a Social Care crisis before the pandemic hit, with the peak of delayed discharge in hospitals being in October 2018, when 11,855 combined days when patients were not able to leave hospital, despite being back to health.
Lothian MSP, Miles Briggs, said: “These figures are very concerning, with the number of patients being stuck in hospital without a suitable destination, returning to pre pandemic levels.
“In Edinburgh and the Lothians there has been a long standing challenge to provide social care, which started to shift towards care in the community.
“We are now seeing increasing numbers of patients not able to leave hospital and the Edinburgh Integrated Joint Board are planning on closing more care homes.
“Patients leaving hospital must have a suitable destination to go once recovered, so that we are not in a position where people are waiting days on end in hospital, when they don’t need to be there.”
A new snapshot survey by the Royal College of Emergency Medicine has found that in August 2021 half of respondents stated that their Emergency Department had been forced to hold patients outside in ambulances every day, compared to just over a quarter in October 2020 and less than one-fifth in March 2020.
The survey, sent out to Emergency Department Clinical Leads across the UK, also found that half of respondents described how their Emergency Department had been forced to provide care for patients in corridors every day, while nearly three-quarters said their department was unable to maintain social distancing every day.
One-third said that the longest patient stay they had had in their Emergency Department was between 24 and 48 hours, with seven per cent reporting the longest stay to be more than 48 hours.
Dr Ian Higginson, Vice President of the Royal College of Emergency Medicine, said: “It is shocking to see the extent of the challenges faced by Emergency Departments across the UK.
“Holding ambulances, corridor care, long stays – these are all unconscionable practices that cause harm to patients. But the scale of the pressures right now leaves doctors and nurses no options.
“We are doing all we can to maintain flow, maximise infection prevention control measures, and maintain social distancing. Our priority is to keep patients safe, and ensure we deliver effective care quickly and efficiently, but it is extremely difficult right now.
“The data is stark, and this is August. Our members are really worried about what may come in autumn and winter. We have a duty to our patients and staff. Currently there is extremely high demand – for a number of reasons – but demand is not the whole picture.
“Demand presents a challenge because of the limitations of hospital space, workforce shortages, difficulties arranging quick ambulance handovers, smooth care and safe discharge of patients from wards, and a lack of services and alternatives to admission, particularly in the evenings and at weekends.
“The health service entered the pandemic short of staff, with less beds, and underprepared. Throughout the pandemic these shortages have been felt, but with demand higher than ever before, and with a workforce that is burned out, these shortages are felt more acutely than ever.”
Commenting on the increase in ambulance handover delays, Tracy Nicholls, Chief Executive of the College of Paramedics, said: “The College of Paramedics’ members also speak passionately about the potential for harm to those patients who, as a consequence of these lengthy ambulance handover delays, can wait an unacceptably long time for help. It is deeply concerning.
“Like the Royal College of Emergency Medicine, we recognise that all partners are working exceptionally hard to manage this situation and current demand. The reality is, however, that unless effective actions are taken now to ease the system pressures, more and more patients will face these delays as we head into another difficult winter, and both paramedics and ambulance clinicians across the UK will face the brunt of any further increase in demand.
“We urge NHS leadership to take action now to mitigate this risk wherever possible and protect both patients and our collective workforce from the inevitable pressure that we face if nothing is done.”
The survey also found that over 80% of respondents had little or no confidence in their organisation’s ability to safely and effectively manage the current or predicted combination of pressures as we head into winter.
Dr Higginson continued: “The final response that found an overwhelming lack of confidence signals something deeply troubling.
“The College has consistently warned of the upcoming winter and ongoing pressures. It is time we saw leadership and an equivalent response. There must be a comprehensive plan for the current demand and upcoming winter that include short- and long-term solutions to tackle these serious challenges.
“If ambulance services and Emergency Departments cannot cope with ongoing pressures, then it is patients and the workforce looking after them who will suffer. The winter could lead the health service into a serious crisis. Patients and staff must have assurance that they, their Emergency Department and their hospital will get what they need to manage.”
A new, pilot mechanical thrombectomy service for stroke patients in the East of Scotland has been launched today.
The pilot will be based at the Royal Infirmary of Edinburgh and will help pave the way for an eventual national service set to benefit hundreds of people who have been struck with a life-threatening stroke.
John Watson, Associate Director of the Stroke Association in Scotland said: “This service is long awaited, overdue, but very welcome indeed.
“Thrombectomy is a remarkable procedure. It involves inserting a long tube into an artery in the leg, which is then fed through the body to reach the blood clot in the brain. The blood clot is then captured in a mesh and pulled out.
“The removal of the clot allows blood flow to resume and oxygen to reach the brain, halting the damaging effects of the stroke. These are blood clots which are too big to be broken down by clot-busting drugs and are usually associated with severe strokes and the worst outcomes for patients.
“Around one in every three people who receive a thrombectomy following their stroke will be less disabled as a result. Around one in five will be able to function completely independently afterwards.
“Thrombectomy has the power to save lives and reduce disability for around one in every ten people who have a stroke.
“The Edinburgh-based pilot is an important milestone on the road to a national 24/7 thrombectomy service for Scotland. A pilot service for the North of Scotland based in Dundee, has been underway since November last year, and we look forward to a third thrombectomy centre in Glasgow coming online next year.”
In addition to improving quality of life, thrombectomy generates substantial savings for the NHS by reducing the need for other interventions or care in the future. Research indicates that, on average, every thrombectomy procedure saves the NHS £47, 000 over a 5-year period.
A stroke is a brain attack. The effects can be devastating. Stroke is a leading cause of severe adult disability. Almost two thirds of survivors leave hospital with a disability. Many have problems with speech and communication, thinking and vision. It can also affect peoples’ emotions and personality.
Alison Maclean, 72, from Dundee had her stroke just before lockdown in January 2020. It was a massive stroke that could have taken away her independence, but following a thrombectomy, she regained full function and has gone back to the life she had before her stroke, almost unchanged.
Angela said: “I am back to doing all the things I did before my stroke: seeing friends and family, reading, watching telly, going on my exercise bike and for walks.”
See foot of article for Angela’s story
John continued: “We want all eligible patients to have access to this game-changing treatment, as quickly as possible. But thrombectomy cannot deliver in isolation. It needs to be part of a new, re-shaped service covering the whole pathway from 999 call, to hospital treatment, recovery and rehabilitation.
“The Scottish Government recognises the need for stroke improvements, which is extremely encouraging. It already has a draft framework of what its own advisors, stroke clinicians and the wider stroke community including the Stroke Association want to see. This is the result of good work by all involved.
“We look forward to seeing the final report and recommendations at the end of the year. But of course, it is the delivery of change and improvement that really matters so we look forward even more, to a commitment early next year to publish a plan to deliver on it.”
Alison Maclean’s stroke story of receiving a thrombectomy
Alison Maclean, 72, from Dundee had her stroke during lockdown in January 2021. It was a massive stroke and she received a thrombectomy resulting in enormous success. The stroke could otherwise have left Alison unable to talk or walk.
I had an accidental fall on 21 Jan 2021. I rang NHS24 in complete agony. Two dayslater I was in hospital getting it checked out.
I had a fractured femur which was put in a plaster-cast and an operation was planned on 26th Jan 2021. On the morning of my operation, I suddenly developed left sided weakness, vision difficulties and problems speaking.
The doctor in the orthopaedic ward called for help. I don’t remember very much other than being asked to lift my arm and lift my leg and answer questions.
I thought I was ok, but the next thing I remember is the doctor telling me that he thought I might have had a stroke. I believe I was rushed in to a room to get a brain scan following which I underwent a thrombectomy. Apparently some blood had leaked from my femur bone causing a clot thereafter the stroke.
The next thing I remember was being in ICU. A nurse came up to me and told me that I’d had a stroke and had just received a procedure to remove a blood clot to help with my recovery.
I was quite relaxed about being told about the fact that I’d had a stroke, but my son called me and he was very distressed about it. I guess he had had to deal with the stress of seeing his Mum in a life-threatening situation making decisions on my behalf. I was unaware of how ill I was at the time, so there are big gaps in my recollection of what happened.
I felt fine following the procedure and apart from my hand shaking uncontrollably for the first day, everything else seemed normal. I was discharged on 2 February 2021. I feel great, just the same and I am back to doing all the things I did before my stroke: seeing friends and family, reading, watching telly, going on my exercise bike and for walks.
Lockdown has been absolutely fine. I’ve been in a bubble, so have had some company and when lockdown eased briefly last summer, I met a few friends and we’d have a cup of tea and biscuit together.
I am very positive about thrombectomy and the fact it probably saved my life. It should be available to everyone who needs it. My life is back to normal and that may never have happened if I had not received a thrombectomy.
As part of the Edinburgh Health & Social Care Partnership’s Summer Season Conversations, community researchers will be in Fresh Start Pantry on Wednesday (8th September) from 9.30am – 12.30pm to meet with members of the local community to chat about wellbeing and what it means to them.
Fresh Start will host this as safely as possible and it will be a drop in session with track and trace upon entry and social distance within the space.
Sir Chris Hoy led the way today as he joined hundreds of other cyclists on a charity cycle from Glasgow to Edinburgh to raise money to help build two new villages for people experiencing homelessness.
The Olympic legend completed the 60-mile route to support Social Bite’s ‘Break the Cycle’ campaign which has so far raised over £700,000 as it aims to fund the creation of two new Social Bite Villages in Glasgow and London.
The cyclists set off from the Sir Chris Hoy Velodrome and pedalled through to the finish line in Edinburgh, near the Social Bite Village in Granton on Sunday 5 September.
Each of the participating cyclists fundraised since the campaign launched earlier this year, with entrants having access to a host of special prizes, including naming a house at one of the new villages and a signed medal from Sir Chris.
Amongst the 540 participants was former Scotland Rugby player, John Barclay, as well as residents and staff from the Social Bite Village in Edinburgh.
TV fitness guru, Mr Motivator, was also on hand to warm the cyclists up on the start line and welcome them over the finish line at the end of their journey.
Josh Littlejohn MBE, CEO and Co-Founder of Social Bite, who also completed the cycle, said:“It’s fantastic to have the opportunity to cycle alongside a sporting hero like Sir Chris and the hundreds of other passionate supporters that completed the route alongside us.
“Having so many people support the cause is incredibly humbling and Sir Chris’ backing of this campaign has been a major boost in our efforts to raise money for two new villages for people in a situation of homelessness.
“We’re working very hard behind the scenes on the plans for two further Social Bite Villages in not just London and Glasgow but other major cities as well, and the money from Break the Cycle will help turn these plans into a reality. We’re all very grateful to all of our supporters and partners who have helped push the campaign forward.”
As well as the charity cycle, the fundraising campaign has been open to all levels of fitness and ability, with people across the UK taking part in virtual challenges since March to raise money.
Challenges have ranged from long distance challenges, through to different exercise routines depending on what suited people best.
Sir Chris Hoy said:“I’ve been a huge supporter of Social Bite and the incredible work it does for a number of years now.
“I’ve seen the positive impact the charity has on so many people’s lives and I’m really thankful to everyone who has been able to support the Break the Cycle campaign so far.
“It was fantastic to meet all the other cyclists and join them for the ride which will make such a difference to the lives of people experiencing homelessness.”
Since opening in July 2018, Social Bite’s Edinburgh village in partnership with Cyrenians has helped 43 people find their feet again, 100% of the residents in a recent survey preferred living at the Social Bite Village over Hostels or B&Bs.
The village offers a supportive community to help people build an independent life, with the village blueprint offering an alternative to how society responds to homelessness.
Money raised from the Break the Cycle campaign will go towards creating the two highly supported communities with the pro bono help of engineering firm Arup.
10% of funds raised from the event will also be donated to SAMH, the Scottish Association for Mental Health and further funds will be invested in Social Bite’s mission to Break the Cycle of homelessness by providing food, employment opportunities, and housing projects.
World Suicide Prevention Day takes place next Friday – 10th September 2021. This year the international theme is ‘Creating Hope Through Action’.
NHS 24 are encouraging everybody to think about taking one simple action to create hope and support ourselves and people around us who might be struggling, before pressures become a crisis. NHS 24 are supporters of United to Prevent Suicide.
The short animation ‘Ask, Tell – A healthy conversation’ gives practical tips on how and when to have compassionate conversations with people who may be experiencing suicidal thoughts or mental distress.
Anyone in Scotland in need of urgent help with their mental health can contact the NHS 24 Mental Health Hub on 111. This service is available 24/7/365.
Many people who call are experiencing thoughts or worries about suicide. The teams are able to help in a number of ways with compassionate listening, strategies to stay safe, or referral to support services for practical help with problems such as money or relationships.
Some callers are referred to their GP or community mental health team. Occasionally they refer callers to emergency services. NHS 24 work closely with the Scottish Ambulance Service and Police Scotland to offer a compassionate, appropriate, safe response to everyone calling.
The Breathing Space service is a confidential phone line for anyone in Scotland over the age of 16, feeling low, anxious or depressed.
Open Monday – Thursday 6pm to 2am, and all weekend Friday 6pm -Monday 6am.
Call free on 0800 83 85 87
Donald Macintyre, Associate Medical Director, NHS 24 said: “Taking care of our mental health has been so important during the pandemic.
“I would encourage everyone to take a small action to improve their own wellbeing and to learn about safe ways to have what might be a difficult conversation with someone who may be struggling. Often a brief, caring chat can have a major impact. Our mental health teams are here to offer a compassionate response to anyone who needs urgent help.”
An action could be as simple as trying out the new Mental Wellbeing Signposting tool on NHS inform, which helps users navigate to free online courses provided by the SilverCloud platform or to the most helpful mental wellbeing resources on NHSinform.
SilverCloud courses have been designed by clinical experts and provide support for a range of conditions including sleep problems, general mental wellbeing and stress.
New research by Acas has found that over a third (36%) of British employers have seen their mental health support improve since the start of the coronavirus (COVID-19) pandemic.
Acas commissioned YouGov to ask businesses in Britain about whether they had seen a change to employee mental health and wellbeing support in their organisation since the start of the pandemic. The poll found that:
Over a third (36%) said it had got better;
Nearly one in ten (9%) said it had got worse;
Half (50%) reported it as staying the same; and
6% of employers did not know.
Acas Chief Executive, Susan Clews, said: “The pandemic has been a challenging period for everyone and it’s great to see that over a third of bosses have managed to improve their organisation’s mental health support for their staff.
“However, nearly one in ten employers have seen this support deteriorate so it is important for businesses to invest in the wellbeing of their workers as they open up again.
“Acas has good advice and training on how to support and manage mental health and wellbeing at work.”
Acas advice for employers on managing mental health during COVID-19 includes:
Be approachable, available and encourage team members to talk to you if they’re having problems;
Keep in regular contact with your team to check how they are coping;
Be understanding towards the concerns and needs of your staff while they work in new or unexpected ways. For example, working from home or managing childcare while working;
Address any individual communication preferences such as asking team members if they prefer to talk over the phone, through video meetings or by email; and
Look after your own mental health and get support if you feel under more pressure than usual. This support could be a colleague at work, a mental health network or a counsellor.
To mark World Suicide Prevention Day Police Scotland has joined forces with partners to arrange a series of drop in events throughout Edinburgh, beginning on Sunday (5th September) at Middle Meadow Walk in the Meadows.
Sergeant Mark Innes from our Prevention, Intervention and Partnerships (PIP) team said:“Suicide should never be inevitable. 805 people died by probable suicide in Scotland in 2020 and we all have a part to play in preventing suicide: it is everyone’s business to help.
“Part of our role at the PIP is to raise awareness of the support provided by our partners in relation to suicide prevention and supporting people bereaved by suicide. We work closely with partners including Chris’s House, SAMH, Survivors of Bereavement by Suicide, Penumbra, Samaritans and many others through Edinburgh’s Health and Social Care Partnership and the Thrive Edinburgh network.
“In the days leading to 10th September we will be holding partnership information stalls throughout Edinburgh to raise awareness of the support available and let people know where they can get help if needed.
A list of where we will be and when will be published soon.Talking can save lives and we hope that we can encourage people to seek support from the people that are best placed to help.”
