NHS Scotland needs 1000 new beds to clear up bed-blocking crisis

Scotland needs 1000 new hospital beds to deal with a bed-blocking crisis clogging up the entire health service. More than 1900 patients are currently trapped in hospital who are well enough to leave, according to the latest figures.

The impact is being felt sharply at hospital doors with lengthy queues at A&E and some hospitals cancelling non-emergency operations.

You are reading: NHS Scotland needs 1000 new beds to clear up bed-blocking crisis

In November, there were 58,501 days spent in hospital by people whose discharge was delayed – bed blocking. This is up 25 per cent on figures from November 2021.

John-Paul Lough-rey, vice president of the Royal College of Emergency Medicine for Scotland, said the situation is so dire in some hospitals that offices and relatives’ rooms are being converted to take an A&E overspill of patients.

Loughrey, who sees the pressure at emergency departments daily as an emergency medicine consultant, said: “We need more beds in Scotland – we are about 1000 beds short. The true problem isn’t too many people coming to see us who shouldn’t be there.

“Our attendance numbers are actually still lower than they were before Covid. Delayed discharge is occupying beds and costs a huge amount of money. It is a huge problem when we already have a shrunken bed base.

Lack of beds is causing delays in A&E.

“It washes through the whole emergency care system, which is evidenced by not being able to move people on and ambulances queuing outside.

“My own experience and that of everyone in emergency medicine is particularly frail, vulnerable and elderly patients attend by ambulance and have to wait six hours or more at times.

“We use a four-hour-safety standard in emergency departments to make sure patients flow into the system in time but after five or six hours there is increased risk of harm or even death by long emergency department stays.

“Previously, a 12-hour-stay was a never event but now we are seeing it in all departments in Scotland. Patients can be spending 24-48 hours on trollies in emergency departments.

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“It is impossible to function efficiently when the department is under so much pressure and emergency is not designed as a ward. The four-hour-standard is the standard. We never want emergency departments to end up counting in days rather than hours.”

He added: “Ambulances should spend 15 minutes at hospital but that is a rare now. We are seeing increased numbers of patients coming by their own car and arriving at hospital in a very poor condition from a serious injury or illness because of the strain the ambulance service is finding itself under.

“They haven’t had the care of a paramedic or technician who could have administered highly practical medicine but they arrive unheralded and we don’t have a space for them.”

He continued: “We have to address social care, patients have to be discharged when they are well, not have long stays in hospital waiting for social care packages or be placed in social care facilities.

“We need to protect staff in emergency departments. Staff are becoming exhausted, burnt out and feel they can’t look after patients any more.”

Dr John-Paul Loughrey – Royal College of Emergency Medicine Scotland

Donald MacAskill,chief executive of Scottish Care, is worried. He said: “I have always said it is a whole system problem. The pressures the NHS is facing are the same as social care is facing, to address just one is intolerable and unsafe.”

He insisted the crisis is the worst he has ever seen and blamed Brexit. MacAskill cited the “short-sighted immigration policies of (Boris) ­Johnson”.

He added that while workers had been brought in from outwith the EU, they were not enough to replace those lost.

He also highlighted “haemorrhaging of people leaving to go to other sectors who were able to offer better pay and conditions” after the first two Covid waves.

“No disrespect to those in retail but to be a social care worker you have to be registered, qualified and the expectation in terms of behaviour and conduct is equivalent to a doctor in that there is a fitness-to-practise regime.

“There is a very high standard of professional conduct. We have to make sure there are appropriate qualifications, regulated and overseen, all that expectation on someone earning £10.90 an hour.

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“It is inevitable if we are not prepared to pay a frontline carer a value we denote to care, we will always have a care crisis.”

MacAskill pointed out more carers in the community would not only help the well patient get out of hospital more quickly but would also prevent people from going into hospital in the first place.

He argued: “People are also staying in hospital longer than they did before Covid because of the state of decline when they went in and the need for rehabilitation. More people need social care because of the inevitable level of deterioration.”

He said there was a need to expand the system of allowing patients to ­rehabilitate in care homes rather than staying in hospital where they are more vulnerable to Covid, flu and Strep A.

First Minister Nicola Sturgeon has moved towards this model and aims to provide 300 more care home beds. But MacAskill said the real answer was in “radically investing in and resourcing social care so people can be prevented from going into hospital”.

He added: “People need to remember one week in hospital for a patient well enough to leave costs £3000.

“That could easily support two or three living independently in the community or in a nursing home with 24/7 care and support.”

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