“The current situation is not sustainable; it is dangerous for patients and becoming incredibly difficult for staff.” – Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland
A substantial new investment of over £300 million in hospital and community care has been unveiled to help tackle what is anticipated to be the toughest winter the NHS and social care system has ever faced.
The new multi-year funding will support a range of measures to maximise capacity in our hospitals and primary care, reduce delayed discharges, improve pay for social care staff, and ensure those in the community who need support receive effective and responsive care.
The NHS and Care Winter Package of additional funding includes:
- Recruiting 1,000 additional NHS staff to support multi-disciplinary working
- £40 million for ‘step-down’ care to enable hospital patients to temporarily enter care homes, or receive additional care at home support, with no financial liability to the individual or their family towards the cost of the care home
- Over £60 million to maximise the capacity of care at home services
- Up to £48 million will be made available to increase the hourly rate of social care staff to match new NHS band 2 staff
- £20 million to enhance Multi-Disciplinary Teams, enable more social work assessments to be carried out and support joint working between health and social care
- £28 million of additional funding to support primary care
- £4.5 million available to Health Boards to attract at least 200 registered nurses from outwith Scotland by March 2022
- £4 million to help staff with their practical and emotional needs, including pastoral care and other measures to aid rest and recuperation
Health Secretary Humza Yousaf said: “As the winter period approaches, it is vital that we do all we can to maximise the capacity of the NHS and social care system. That’s why I’m setting out our £300 million NHS and Care Winter Package today.
“We cannot look at the NHS in isolation we must take a whole systems approach and these measures will help alleviate pressure across the NHS and social care.
“This significant new investment will help get people the care they need as quickly as possible this winter. Bolstering the caring workforce by increasing their numbers, providing them with additional support, and increasing the wages of social care staff.
“We’ve previously provided funding to ensure that adult social care staff are paid at least the real living wage. Today we’re going further and our new investment will ensure that adult social care staff who are currently paid the real living wage will get a pay rise of over 5%
“Measures I have announced today will help patients whose discharge has been delayed waiting for care and help get them out of hospital and on to the next stage in their care. This helps the individual by getting them the right care, and helps the wider system by ensuring the hospital capacity is being used by those who need that specialist level of clinical care.
“This £300 million of new funding will also fund increases in social care capacity in the community and in primary care – helping to ease the pressure on unpaid carers.
“Our NHS, social care staff and social work staff have been remarkable throughout the pandemic and today’s additional investment will help support them to deliver care to people across Scotland this winter.”
Meanwhile,the latest Emergency Department performance figures for Scotland published by the Scottish Governmentyesterday for August 2021 show that four-hour performance has deteriorated for the fourth consecutive month, again reaching a record low – while the number of patients staying in a major Emergency Department for 12-hours or more reaches a record high.
In August 2021 there were 117,552 attendances to major Emergency Departments across Scotland.
Data show that four-hour performance reached a new record low, with 75.4% of patients being seen within four-hours. One in four patients stayed in a major Emergency Department for four-hours or more before being admitted, transferred or discharged.
The number of 12-hour stays in August 2021 nearly doubled when compared to July 2021. 1,346 patients stayed in a major Emergency Department for 12-hours or more, compared to 760 in July 2021. This figure increased for the fourth consecutive month and it is the highest number of 12-hour stays since records began.
Data also show that 5,279 patients spent eight hours or more in a major Emergency Department. This is the highest figure since records began. The number of patients delayed by eight-hours or more increased for the fourth consecutive month.
Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said: “The challenge for health care workers is growing significantly. In Scotland, the army have been called in to assist the ambulance services.
“In Emergency Departments, long stays are rising drastically, and one in four patients are staying in an Emergency Department for more than four-hours. It is extremely worrying. These pressures are likely to mount further, and performance deteriorate even more as we head into winter.
“We are seriously concerned about patient safety. Long stays put patients at risk, particularly vulnerable patients, and especially with covid still present in the community. We urgently need a plan to increase flow throughout the hospital, to reduce exit block, to prevent crowding, and to ensure that patients who need it can quickly be moved into a bed for their care.
“The current situation is not sustainable; it is dangerous for patients and becoming incredibly difficult for staff.
“We welcome this afternoon’s announcement by the Secretary of State for Health and Social Care, Humza Yousaf MSP, including the recruitment of more staff and funding for hospital and community care. We hope that these measures will begin to alleviate pressures across the health system, and in particular reduce ambulance handover delays, long stays in Emergency Departments and exit block in our hospitals.
“However, while we welcome this investment, short-term cash injections do little to resolve long-term problems. We must see a long-term workforce plan that includes measures to retain health workers, particularly Emergency Medicine staff, as well as a long-term strategy for social care.”
Responding to the Scottish Government’s announcement to uplift care workers pay to just over £10 an hour, GMB Scotland Secretary Louise Gilmour said: “If we want to tackle the understaffing crisis in social care then we need to substantially increase the basic rate of pay, and for GMB that mean’s a £15 an hour minimum.
“Many of our frontline services are already being delivered on the back of wages of just under or over £10 an hour, and we know this isn’t nearly enough.
“To transform social care for the people who need it and the people who deliver it, particularly as we roll-out a national care service, then we must go further.”
The Scottish Government may also be facing industrial action from nursing staff over the winter …
NHS pay dispute in Scotland: Royal College of Nursing members to be asked about willingness to take industrial action
RCN members working for NHS Scotland are to be asked what industrial action they would be willing to take in support of their ongoing trade dispute with the Scottish government and NHS employers over pay.
The trade dispute was lodged in June following the Scottish government’s decision to implement a single-year NHS pay deal for 2021-22 for Agenda for Change staff, without further discussing RCN members’ overwhelming rejection of the pay award.
The indicative ballot will open on 12 October and close on 8 November.
Eligible members will receive information on the different forms of industrial action.
The indicative ballot will be run by Civica, the independent scrutineer that organised the consultative ballot earlier this year. Eligible members will receive an email from Civica with a personal link to the online voting site on Tuesday 12 October. Weekly reminder emails will also be sent.
The result of the indicative ballot will not formally authorise industrial action. It will be used to inform the next steps RCN members might take.
Julie Lamberth, Chair of the RCN Scotland Board, said: “Industrial action is always a last resort but the current staffing challenges are causing unacceptable risks to patients and staff. The Scottish government has the opportunity to do the right thing by nursing.
“I would urge all eligible RCN members to seek out the available information on what taking industrial action means and what the implications of doing so might be. We need each member to make up their own mind and have their say in the ballot.”
Colin Poolman, RCN Scotland Director, added: “This is your chance to speak up – for your patients and your colleagues. Many of you rejected the pay offer and you know the link between fair pay and safe staffing.
“This is your opportunity to tell us what action you are prepared to take. To let the Scottish government know that the time to protect patient safety and value the safety critical role of nursing is now.”