Lizzy Buchan: A classic case of good intentions going awry?

Hundreds of patients are stuck in acute facilities and cannot be discharged because of a lack of social care. Picture: Ian Georgeson

Hundreds of patients are stuck in acute facilities and cannot be discharged because of a lack of social care. Picture: Ian Georgeson

Share this article
1
Have your say

Keeping people out of hospital is a win-win situation for everyone.It allows more hospital beds to be free for emergencies, prevents the spread of infection and, most importantly, allows people to be cared for in the community at a lower cost.

Both medics and patients seem to be broadly supportive of shifting care away from hospitals, which is just as well as it is pretty clear that the NHS cannot continue to operate in its current form.

It is difficult to make something as long-winded as health and social care integration sound exciting but we need to take note as it has been hailed as the biggest reform since the NHS began in Scotland.

From Friday, 31 new quangos will be managing close to £8 billion of care resources as NHS and local council services join forces in every local authority area.

The problem is not the idea, which is emminently sensible.

It should help to ease the burden of bed blocking on hospitals, where hundreds of patients are stuck in acute facilities and cannot be discharged because of a lack of social care. More funding for social care should also play a preventative role so older patients can live for longer at home without emergency hospital stays.

The problem is that the idea seems to be moving faster than the current system can keep up with.

Anyone who works in the NHS, or closely with it, will know that it can be a rather unwieldy beast, a monolithic structure that refuses to bend to anything but the strongest of wills.

There have been low rumblings for months that these quangos are not ready for 1 April.

Although some have been operating in the background for months, there are concerns that the boards could be inheriting chaotic and debt-ridden services.

Audit Scotland cranked things up a notch by publishing a tough report recently that claimed the new care partnerships were facing a shaky start due to a lack of leadership from the Scottish Government over its own grand plan.

I have also heard complaints from charities and voluntary organisations that they have not been invited to the table in some areas, although they are working at the front line.

And at a BMA election hustings last week, one doctor raised concerns that beds were being reduced in hospitals without proof that delivering all of this care in the community was going to be appropriate.

A step change of this magnitude needs clear and decisive leadership rather than this slightly muddled picture where everyone wants the same thing but seems to be trying to get there differently. Even if the plans are moving in the right direction, Scotland still needs a strong workforce to carry this out.

While there are staffing shortages in hospitals, these pale in comparison to the dearth of GPs, health visitors and carers who will be involved in much of the community-based care.

Ministers have committed to spending more than £500,000 to ensure the transition is a success, which is a good step but still only a small sum of NHS Scotland’s annual budget.

As the election approaches, I cannot escape the sinking feeling that the whole process has moved too fast.

We have to take the plunge at some point, but it seems that we might have thrown away our lifejackets as well.

Back to the top of the page