Bed-blocking patient figures at 4-year high

In August, 325 patients found themselves well enough to leave Lothian hospitals, but they were forced to remain there – often for weeks on end – as they had nowhere appropriate to be discharged to.

The problem is particularly severe in Edinburgh, with a shortage of care home beds being largely blamed for the increasing figures.

Progress in reducing the number of delayed discharges has been made over the past decade, but at an NHS Lothian board meeting the news that the figures were on the rise again was met with dismay, leading to calls for a new solution.

Eddie Egan, the health board’s outgoing employee director and vice chair, said: “Is it surprising that staff are on their knees in acute services? People with dementia are stuck in busy acute wards not getting the care they require.

“This has been on the board’s agenda at every single meeting for 12 years. One of the things that needs to be examined is, have we got the strategy right?”

George Walker, a non-executive board member, added: “There are 325 people suffering distress by being in beds they don’t need to be in and NHS Lothian is incurring the cost.”

Of the August delayed  discharge patients, at least 17 had been stranded in hospital for six or more weeks and at least 35 had been waiting for a minimum of four weeks. The average excess stay for delayed discharge patients was 22 days.

In June, 8832 bed days in Lothian hospitals were taken up by delayed discharge patients, rising from 7899 in May. Last month, the News revealed that the proportion of hospital beds being taken up by patients who were medically fit enough to leave Lothian hospitals was the highest in Scotland, at 7.3 per cent.

Ricky Henderson, the city’s health leader, said there was “no denying” that there was a problem with bed blocking in Edinburgh and that dealing with the issue was a priority.

He said: “It’s a problem on two counts – it’s more expensive to keep people in hospital and it doesn’t help people recover. I’m hopeful that with the integration of health and social care, we’ll find a vehicle to work more collaboratively with other agencies and make progress. This needs to be tackled.”

It is hoped that more care home places will become available in the Capital in the next six months. A phoneline service for GPs to receive advice from elderly care specialists and an increase in the number of senior doctors in the “front door” of the Royal Infirmary are being trialled with a view to reducing unnecessary admissions.

Professor Alex McMahon, NHS Lothian’s director of strategic planning, said: “No-one should have to stay in hospital longer than is necessary, and we are working closely with our local authority partners to ensure patients do not have to stay in hospital once their treatment is complete.

“We are taking a new approach to unscheduled care which is being led by our nurse director and the director of health and social care, Edinburgh Community Health and Care Partnership. Through more integrated working across GPs, acute hospitals and community care, this improvement programme aims to develop a balance between capacity and demand across home care, care homes and NHS beds.”