Care homes crisis: Scottish Government urged to hold 'urgent talks' as one care home closes every week

Doctors are calling for the Scottish Government to intervene on the back of Scottish Care’s warning that the nation is losing one care every week.

Top medics have called on the Scottish Government to hold “urgent talks” over the future of the country’s care sector, amid warnings that homes are closing at a rate of one a week.

Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh (RCPE), said his organisation was “deeply concerned” about care home closures, warning these could impact on NHS care over the winter.

This year NHS Scotland experienced the worst emergency department waiting times in its history, due to unprecedented pressures caused by vacancies, growing waiting lists and the aftermath of the coronavirus pandemic.

Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh (RCPE), said his organisation is “deeply concerned” about care home closures, warning these could impact on NHS care over the winter.

Stressing the “decline in care home capacity is felt across the whole system”, Prof Elder insisted action was needed from ministers as a “matter of urgency”.

His comments come after Scottish Care – the body that represents the independent care sector – said the “significant pressures” it faced had resulted in the “largest number of care home closures” in recent months, with a “very real fear” these will “escalate at speed”.

In a statement issued earlier this month, the organisation warned: “Every week at least one care home is closing down. Unfortunately, it is the small, rural and remote private and charitable care homes which are not managing to continue operating. This is an especial risk in Scotland where most private providers are small, family-run businesses.”

Prof Elder said: “The college is deeply concerned that care homes in Scotland are closing at the rate of one every week. Care homes not only provide long-term care for older people, but often act as a bridge from hospital to home.

“A major cause of the flow difficulties experienced in acute care in recent years has been ‘exit block’ – the difficulty in supporting patients back to their homes after hospitalisation.

“Capacity in care homes is already stretched and any further reduction will not only have an impact on the NHS Scotland’s ability to provide safe and effective care in its acute wards, but will impact on the dignity and welfare of those patients who are delayed and have to wait inappropriately for weeks or months in hospital wards.

“The impact of a decline in care home capacity is felt across the whole system, contributing to longer waits in emergency medicine and a decline in bed availability for elective surgery in hospital wards.

“Capacity issues are year-round in the Scottish NHS at this time – the winter months only see the situation worsen, hence our warning now that care home capacity must be protected in the coming months.”

With delayed discharges – where patients who are medically well enough to leave hospital have to remain on wards while they wait for care to be put in place – having reached a record high in 2022-23, Prof Elder added: “We urge the Scottish Government and local government stakeholders, as a matter of urgency, to get round the table with the independent care sector and explore all options to support it and help make it sustainable, not least in terms of tackling its very severe workforce challenges.

“We need to have a successful care home sector for both the people who require places within it and for the effective functioning of our NHS as a whole.”

Social care minister Maree Todd said social care services were “absolutely fundamental to our communities”, but it was clear how “challenges like energy costs, the costs of living and Brexit have really impacted the recruitment and retention of staff”.

"The RCPE and Scottish Care have raised important issues and we continue to engage with them and other partners regularly to build a more sustainable workforce that feels truly valued and properly rewarded for their work,” she said.

“We’ve increased pay and are working towards our commitment to increase spend in social care by 25 per cent by the end of this Parliament, an increase of over £840 million. In the long term, we believe the National Care Service will help us and our partners to provide consistency in further improved pay and conditions, access to training and development and ensuring a career in social care is attractive and rewarding – but we are beginning to make those improvements now.

“As well as speaking with care providers, unions, councils and organisations, this summer we are visiting communities to speak to people receiving care, their loved ones and those working in the care sector. We are committed to supporting the social care sector improve, and we are determined that the people within in help drive those changes and I would encourage anyone with an interest to see about joining us at one of these events in person, or online.”

A spokesperson for Cosla, the body which represents Scotland’s councils, said: “In March of this year, local government offered the highest ever increase to the National Care Home Contract rate, recognising the critical role of care homes and their staff in supporting some of the most vulnerable people in our communities.

“We are pleased that Scottish Care members have since voted to accept this offer. Local government remains committed to working with those who deliver, plan and commission social care support to ensure the National Care Home Contract remains fit for purpose by providing stability for the market and supporting the sustainability of care providers within an increasingly difficult environment.

“Cosla continues to work with our partners to build a health and social care system that is resilient year-round, and continuously delivers high quality, effective care and support.”