Scottish care providers call for reform as postcode lottery for elderly patients revealed
Wide regional discrepancies in the speed with which elderly patients declared medically fit to leave hospital are discharged are exposed in ground-breaking new research by the UK’s largest and most comprehensive later-life care directory, Autumna.
The survey of more than 500 care homes and home care agencies has revealed the best and worst performing regions for speed of discharge from hospital, as well as communication between hospital discharge teams and social care providers, with nine in ten providers calling for reform of the system.
100% of care providers questioned in Scotland want the government to reform the hospital discharge process, regardless of whether or not they receive referrals from it. This reflects that the system is among the worst performing in the country.
42.9% of respondents say they don’t have a positive relationship with hospital discharge teams (34% nationally). Only one in five providers receive referrals at least weekly, suggesting a lack of effective communication which may also contribute to slow patient admission: 50% of providers say discharge from hospital takes more than a week (24.3% nationally), with 14.3% saying it takes three weeks or more (nearly twice the national average).
93% of care providers nationally would like to see government reform of the hospital discharge process, with the figure ranging from 85.7% in the North East to 100% of providers in Scotland. Nationally, 85% of care providers who have a positive relationship with their local hospital discharge teams still want the process reformed.
“Our survey, which is the first to probe the experiences of social care providers of the hospital discharge system, shows a system that is failing due to poor relationships caused by poor communication,” warns Debbie Harris, the founder and Managing Director of Autumna, which has developed a digital solution to speed up hospital discharge*.
“Our findings are a wake-up call to Kier Starmer and Wes Streeting that the system is broken and urgently needs reforming. The pressures are only going to get worse as our population gets older, so we need to fix the system now, before it completely breaks down,” she adds.
Delayed hospital discharge costs the NHS around £4.8 million a day1. It also results in: worse health outcomes for elderly patients; other patients not being able to access hospital services; and increased pressure on local authorities, as elderly patients who are stuck in hospital end up with greater care needs.
“Autumna’s Hospital Discharge Report: Care Providers’ Perspectives clearly outlines a system that is failing and will only get worse unless remedial action is taken,” comments Professor Martin Green OBE, Chief Executive of Care England.
“However, this report also highlights the fact that there are solutions, and if people worked effectively with the social care sector and gave it the needed resources, the solutions would be easily and readily available.”
Autumna’s research shows that four in ten social care providers do not receive referrals from hospital discharge teams.
“We have elderly patients stuck in hospital when there is sufficient care to support their discharge, either in a care home or with support at home,” comments Harris. “Hospital discharge teams do not have effective tools to identify available, appropriate care quickly and are overly reliant on some providers, meaning elderly patients are denied access to the full range of appropriate support available to get them out of hospital.”
48.7% of care providers do not feel the hospital discharge teams understand the care they offer. A third of providers (33.4%) say they can’t talk to discharge teams when they need to. Of the care providers who do receive referrals from hospital discharge teams, a similar number (34.0%) say they don’t have a positive relationship with them.
17.0% of care providers questioned say the average length of time for discharge into their care after a patient has been declared fit to leave hospital is one to two weeks, while 7.3% say the average length of time is three or more weeks.
The top reasons for delays in patient transfer to social care providers are because the funding is not agreed, there is insufficient information and lack of communication. 45.5% of care providers say information provided by hospital discharge teams is not accurate. 44.6% of care providers think the information provided by hospital discharge teams is insufficient to make an initial assessment on admission suitability.
“The care sector has the capacity, the expertise and the enthusiasm to be part of the solution,” advises Harris. “What’s more, speeding up hospital discharge will help the commercial viability of providers who face increasingly squeezed margins; 518 care homes closed in 20232, with a loss of 14,169 beds2.
More than 15 million people are projected to be over the pensionable age by 20453, with the number aged 85 and over expected to increase by 1 million to 2.6 million over the same period4.
“With an ever-ageing population, continuing to fail to find a solution to speedy, efficient and appropriate hospital discharges is unsustainable – for the NHS, for local authorities, for the taxpayer, and – most importantly – for our elderly,” urges Harris. “We challenge the government, health and social care leaders to think imaginatively to rise to the challenge.”
For a summary of regional discrepancies, see page 4. For full national and regional results, incl. quotes from local care providers, download the full report: www.autumna.co.uk/hospital-discharge-report-2024/
Students across Lothian are encouraged to ensure their vaccinations are up to date before heading off to college or university this year.
Infectious diseases such as meningitis, septicaemia (blood poisoning) and measles can spread easily in universities and colleges. Vaccination offers the best protection against these diseases, which is why it’s important to check your vaccines are up to date.
Students are 11 times more likely to develop invasive meningococcal disease, which causes meningitis and septicaemia. The meningitis ACWY (MenACWY) vaccine helps to protect against these very serious diseases. Students who have missed having the vaccine, can get it up to the age of 25 years.
Parts of the UK and other countries in Europe have been seeing an increase in the number of people getting measles, and evidence suggests students are at higher risk. That’s why it’s important to check you’ve had two doses of the MMR vaccine, which protects against measles, mumps and rubella and has saved over 4,500 lives across the UK.
Pat Wynne, Nurse Director for Primary and Community Care, NHS Lothian, said: “These diseases can be severe and, in some cases, life threatening.
“Students are at increased risk due to the large amounts of mixing with new people in enclosed spaces. Increasing cases of measles and meningococcal disease in particular were observed earlier this year.
“Vaccines are the best way to ensure you’re protected and these are offered for free on the NHS in Scotland. These vaccines are offered as part of the routine childhood immunisation schedule however if they’ve been missed, it’s not too late to catch up.
“Ideally, they should be given at least two weeks before the new semester starts.”
There is also still time to get the human papillomavirus (HPV) vaccine. It helps protect against HPV-related cancers including head, neck and cervical cancer and also protects against over 90% of genital wart infections. Most students will have had the HPV vaccine at school if eligible but if not, students may still be able to get it up until the age of 25.
If you are under 25 years and you’ve missed any vaccinations, call the Vaccination Enquiries Line on 0300 790 6296. If you are 25 or over, call your GP practice. They can check your records and arrange a referral if it is required.
International students may be able to get additional vaccines that were not available where they lived before.
The platform, which provides a safe place to find advice, local support, tips, and tools to help maintain positive wellbeing, was launched at Bonaly Primary School this week (Wednesday 21 August).
The online space features a series of short films where children and young people from Edinburgh schools discuss why it’s important to talk about feelings and share their tips for emotional wellbeing.
There is also advice on apps, information on local supports and signposting to other websites that provide other sources of helpful advice and resources which include helplines and chat-based support.
It follows research which shows that understanding our emotions and learning coping mechanisms can help prevent more serious health problems later in life.
Education, Children and Families Convener Joan Griffiths said: “The wellbeing of our children and young people is at the heart of everything we do, and we understand they’ll face challenges which might cause them to struggle with their feelings and emotions.
“The launch of this new online platform marks a positive step forward in providing them with the tools and resources they need to take care of their mental health and wellbeing.
“Whether they’re seeking advice, finding support or want to connect with others, the platform is designed to be a go-to digital space. I’m confident it will make a real difference to the lives of Edinburgh’s children and young people.”
Gillian Barclay, Depute Principal Psychologist, said: “It’s normal to feel anxious, angry, sad, or frustrated some of the time, but recognising that we are struggling with feelings or emotions is really important. The new platform aims to support children, young people, and the adults around them to maintain positive wellbeing.
“I hope children, young people and their families in Edinburgh will find it helpful. We’ll continue adding information, support and resources and welcome feedback, particularly from young people and families, to help us do this.”
Funding for projects to benefit patients and clinical staff
A total of £1.5 million funding in 2024-25 is supporting 12 projects to continue providing direct and personalised support to patients with cancer.
The Single Point of Contact (SPoC) pilots provide patients with ongoing contact to support them, putting them at the heart of all decisions and actions involving them throughout their care journey.
The NHS Lothian SPoC uses a centralised digital hub delivering telephone communication and support to patients with a range of cancer types.
Around 40% of calls are diverted away from Clinical Nurse Specialist workload, which has led to improvements in the quality of their telephone contacts. Patient engagement work carried out by NHS Lothian and Healthcare Improvement Scotland has indicated high satisfaction with the service.
Confirming the funding, which is included in the 2024-25 Budget, as he met nurses at Edinburgh Cancer Centre with experience of the service, First Minister John Swinney said: “We are fully focused on improving cancer survival, and delivering excellent and accessible care is at the core of how we do that.
“The Single Point of Contact Service meets requirements identified by Boards to deliver improvements in communication and support for patients with navigating cancer care.
“By taking in the region of 2,000 calls per month and providing person-centred support to those patients throughout their care journey, the Edinburgh Single Point of Contact project provides consistent access for patients to have conversations about their care, freeing up capacity for specialist staff to focus on the most complex cases.”
Katie Gibson, Neuroendocrine Tumour Clinical Nurse Specialist at the Edinburgh Cancer Centre, said: “I’ve seen first-hand how the SPoC service has transformed our ability to care for cancer patients.
“The centralised system streamlines communication and allows us to spend more quality time with those who need it most.
“As a result, patients are aware of who to contact for the support and advice they require from diagnosis , treatment and beyond.”
Over £1.5 million will support 12 pilot projects across Scotland to deliver a single point of contact to people diagnosed with cancer.
Funding has been delivered in response to needs identified by individual Boards and proposals submitted by them, pilots vary by cancer type and location:
NHS Lothian has received £ 343,740 to support the telephone-based SPoC service at Edinburgh Western General, serving boards within the South East Scotland Cancer Network
NHS Borders has received £82,000 for 3 cancer care co-ordinators, providing support across a variety of cancer sites
NHS Dumfries and Galloway has received £71,000 for 2 cancer co-ordinator posts, providing a telephone-based support service across a range of tumour sites
NHS Fife has received £107,354 to staff a Single Point of Contact Hub, dealing with all urgent suspected cancer referrals.
NHS Forth Valley has received £67,556 for 2 healthcare support workers (HCSW) providing a single point of contact for 7 tumour groups
NHS Ayrshire and Arran, NHS Forth Valley, NHS Greater Glasgow and Clyde, and NHS Lanarkshire have received total funding of £202,668to develop a regional approach to digital remote follow up of prostate cancer patients in the West of Scotland
NHS Greater Glasgow and Clyde has received £67,566 for 2 support workers to augment specialist gynaecological nursing support and £141,324 for 4 SPoC roles across GGC sites to smooth and facilitate the patient journey, for people diagnosed with lung cancer
NHS Grampian has received £84,500 for 3 posts to provide a joint service with Macmillan Navigators, providing support following an Urgent Suspicion of Cancer (USC) referral
NHS Highland has received £270,680 for 7 Cancer Support Workers providing tailored support throughout diagnostic pathway and onto treatment
NHS Tayside has received £33,288 to provide support for people diagnosed with advanced Upper Gastrointestinal or Hepatopancreatobiliary tumours and lung, renal and prostate cancers
NHS Western Isles has received £68,000 for 2 HCSWs, as part of the Macmillan Team, to support people with all types of cancer
Health Improvement Scotland is currently carrying out a scalability assessment of all 12 projects in order to identify best practice and how best to scale and expand these pilots.
The UK’s leading meningitis charity Meningitis Now is calling for students to recognise the disease as an emergency and ‘sound the alarm’ if they spot its signs and symptoms.
20-year-old University of Manchester student Sophia Speirs nearly died from meningitis in 2023, but says her life was saved thanks to her mum and her university flatmates who sounded the alarm by calling the emergency services who rushed her to hospital.
The student who is originally from Hertfordshire is joining forces with Meningitis Now to call for more people to recognise the disease as an emergency which needs swift action.
Sophia says, “I had just celebrated my 19th birthday and five days later I was fighting for my life in intensive care.
“I woke up feeling incredibly achy, which quickly turned into violent sickness. I was telling people I had a sick bug but I knew something was really wrong – I just didn’t want to believe it.”
Meningococcal meningitis is an infection of the membranes surrounding the brain and spinal cord. It can be fatal and can kill within 24 hours. Its early symptoms can be mistaken for the flu or even a hangover so it’s vital for students to know when to seek help and ‘sound the alarm’.
Sophia added, “I woke up the next morning feeling even worse. I heard my mum ringing me to check I was ok, but she quickly realised I was unable to speak properly. I was slurring my words. She got me to text my flat mates asking for help.”
“Two of my flatmates then came rushing into my room. My parents also called campus security who came straight away.”
Sophia spent three nights in intensive care in Manchester Royal Infirmary, another nine days in a high dependency unit and a final three days on a regular ward.
The 21-year-old had emergency surgery for a septic joint in her hip, and had myocarditis (inflammation of the heart), as well as permanently losing hearing in her right ear.
Sophia says, “I am grateful to be alive and although I feel unlucky, I know that compared to others I got off lightly! I am really keen to spread awareness. It’s so important that university students know what to do in a case of meningitis.”
Meningitis Now’s student awareness campaign urges parents, universities and students to know how to recognise the signs and symptoms of meningitis, to act fast if they suspect meningitis and seek urgent medical help.
Meningitis Now Chief Executive Dr Tom Nutt says, “Meningitis is an emergency so we’re asking students to make sure they know when to sound the alarm.
If you or a friend are ill and getting worse, it could be meningitis. Sound the alarm by calling 111 or your GP – you could save a life.”
Universities are also being encouraged to order Meningitis Now’s free awareness materials, with the charity aiming to have materials in every UK university over the next five years. Parents can also request a free student meningitis awareness pack at www.meningitisnow.org/students
Symptoms of meningitis include fever, headache, vomiting, muscle pain, dislike of bright lights, and a stiff neck. In cases of septicaemia (which can occur simultaneously), a rash that does not fade under pressure may also appear.
Dr Nutt added: “It’s really important that everyone is aware of the risk of meningitis because it can affect anyone at any age.
“Teenagers and young people are at an increased risk. This is because they are more likely to be carrying the bacteria that cause meningitis in the back of their nose and throats.”
“Vaccines are available to prevent some types of meningitis and most of these are available as part of the UK routine immunisation schedule. However, not all types of meningitis can be prevented by vaccines. Make sure you know the signs and symptoms and seek urgent medical help if you are concerned.”
For further information about the signs and symptoms of meningitis visit:
Heart Research UK Healthy Heart Tip, written by the Health Promotion and Education Team at Heart Research UK
Healthy Heart Tip: Basics of heart health and how you can reduce your risk
Maintaining a healthy lifestyle can be challenging, particularly with the conflicting advice found online and on social media about what is good or bad for your health. Surveys conducted in the UK revealed 33% of men and 31% of women had at least two unhealthy traits that could be harming their health.
Coronary heart disease is preventable. By minimising your risk factors and eating a healthy diet, carrying out regular physical activity, not smoking and reducing your alcohol consumption, you’re helping to keep your heart healthy. In this healthy tip, we ways you can benefit your heart health and basic ways you can look after your health.
Healthy eating
Following a Mediterranean-style diet has been proven to be great for your heart health. This way of eating highlights plant-based foods, lots of fibre and healthy unsaturated fats.
The Mediterranean diet involves consuming lots of fruit and vegetables, wholegrains including wholegrain pasta and rice and wholemeal breads, nuts and seeds, beans and extra virgin olive oil. Moderate amounts of fish, seafood, poultry, eggs, cheese and yoghurt. Little or low amounts of red meat, processed foods, sweets, butter and sugary drinks.
Physical activity
Carrying out regular physical activity will help to strengthen your heart muscle to reduce your resting heart rate and blood pressure. You should aim to carry out at least 30 minutes of physical activity five times a week, this will help you to meet the recommended physical activity guidelines and keep you healthy.
If you’re new to physical activity, then make sure you gradually introduce it into your lifestyle and don’t run before you can walk. Try making the activities part of your daily routine and make sure it’s something that you enjoy doing, this way you’re more likely to continue doing it.
Quitting smoking
Seeking support to stop smoking from professionals will help you to improve your heart health. Try setting yourself a date within the next two weeks when you’re going to stop smoking and make sure to remove all your lighters, matches, ashtrays, cigarettes and any other reminders of smoking from your house.
Within six hours of quitting, your heart rate and blood pressure will improve and within two to twelve weeks your blood will pump more efficiently through your heart and muscles.
Reducing alcohol consumption
Drinking alcohol on a regular basis can increase your risk of developing heart disease, increase your blood pressure and cause weight gain. The NHS recommends no more than 14 units per week spread over three or more days, or skip drinking altogether where possible.
If you do regularly consume alcohol, then try to have more alcohol-free days within your week and make sure to choose lower alcoholic or non-alcoholic options where possible. If you need support to help you to reduce your alcohol consumption, seek professional help and advice from your GP.
Health Secretary Neil Gray has said that the level of drug misuse deaths remains “hugely concerning”, as the latest statistics showed an increase of 121 deaths compared with 2022.
Figures published by National Records of Scotland found that 1,172 people died due to drug misuse in 2023.
This is the second lowest number of deaths since 2017, with 2022 being the lowest.
During a visit to the ‘The Skylark IX Recovery Trust’ boat-building project which helps people dealing with problem drug use, Mr Gray said: “My heartfelt condolences go to all those affected by the loss of a loved one through drugs.
” This level of deaths remains hugely concerning and underlines why we we will continue to do all we can to reduce harm and deaths caused by drugs.
“We’re taking a wide range of actions through our £250 million National Mission on drugs, including opening a Safer Drug Consumption Facility pilot, working towards the opening of drug-checking facilities and widening access to life-saving naloxone.
“We will also continue to improve access to residential rehab, where we’re on track to meet our target for additional placements, and drive the rollout of Medication Assisted Treatment (MAT) standards to make treatment and support available more quickly.
“Despite this unwelcome rise, I believe that National Mission action has led to much being achieved in a short space of time, with projects delivered on an unprecedented scale making a real difference to people.
“We will intensify our efforts and are also working hard to respond to the growing threat from highly dangerous, super-strong synthetic opioids like nitazenes in an increasingly toxic and unpredictable drug supply.
“We’ve seen a 67% increase in funding from 2014-15 to 2024-25 and made record levels of funding, of more than £112 million, available to Alcohol and Drugs Partnerships (ADPs).
“Additional National Mission funding, and support has created momentum in local areas to put services in place to save lives. We’ve now backed more than 300 grassroots projects, including the Skylark IX project in Dumbarton.”
The Dunkirk ‘little ship’ Skylark IX was rescued from the River Leven in 2010, with its restoration leading to a ‘Recovery for Recovery’ initiative helping people from the Alternatives community-based drug project.
Service users now gain hands-on training at its Boatbuilding Workshop in the Scottish Maritime Museum in Dumbarton.
Skylark IX Recovery Trust community engagement officer Amy Dobson said: “Our woodcraft workshops, funded through Corra Foundation, have been a huge success, and received with a lot of enthusiasm from those in the recovery community.
“Most people at our workshops haven’t done any woodwork since high school, and they’re now learning the skills to be able to build wooden oars and paddles for our skiffs and canoes, which will then be used within the wider community.
“Although Skylark IX will never sail again, all of our project work relates back to her story and history. Skylark IX saved lives during Operation Dynamo in 1940, and continues to act as a symbol of recovery and resilience today.”
James Currie, a previous volunteer trainee who returned as trust recovery support staff member said: “Since being a part of the Skylark IX team, I have finally found a purpose in giving back to my community and helping others to see their potential.
“When they go away from the workshops smiling and talking about how they had a nice day, enjoyed the workshop, and found connection, it gives me hope that we can make a real difference to people’s lives.”
