Damning report on Scots hospital care of elderly

THE care of elderly people in hospital is being compromised by staff shortages and a failure to put in place systems which will help them recover faster, according to a damning report on Scottish hospitals by the Royal College of Nursing.

MSP Shona Robison responded to the report. Picture: Ian Georgeson

The study found older people were often not able to be treated on the right ward, offered the correct support for their needs or allowed to be discharged quickly enough, allowing them to recover at home. The study found two thirds of hospitals inspected across 11 health boards were identified as needing to improve some aspect of patient flow, boarding – when care is delivered in the area of a hospital which does not meet a patient’s needs due to bed shortages – or discharge procedures.

“When older people come into hospital, they are often acutely unwell. If our hospitals don’t have enough staff or enough beds and resources to manage the flow of patients coming through their doors, it is hard for them to provide the best possible care for their patients.” said Theresa Fyffe, director of RCN Scotland.

“Based on what we found from our analysis, many of our hospitals just don’t have the right systems in place. They’re struggling to manage, with inspectors reporting that two thirds of the hospitals inspected needed to improve the flow of patients through the hospital, with older people being moved from bed to bed, not being cared for or treated on the right ward for their condition, or not being able to be discharged, so taking up desperately needed beds.”

The analysis of 35 inspection reports by Healthcare Improvement Scotland (HIS) on older people’s care found almost all hospitals inspected did not appropriately screen and assess older people for cognitive impairment, while three quarters of the hospitals inspected needed to improve how they screened and assessed older people for under-nutrition.

A further half of the inspections identified improvements needed in the assessment of pressure ulcers in older people, such as bed sores.

Ms Fyffe called for the Scottish Government to commit to long-term funding and invest in sustainable services

She said: “Scotland has a growing population of older people, who are living longer, often with multiple, complex health conditions, and with the number of people aged over 75 predicted to rise substantially over the next 25 years, the pressures that this will put across the whole system are only set to increase.”

Cabinet secretary for health Shona Robison said: “We’re committed to driving up standards in the care of older people in hospitals, which is exactly why this Government introduced these inspections.

“These inspections are already reviewed regularly by HIS, whose most recent review already identified the points raised by the RCN and action is underway to address them.

“HIS also found that ‘on average, 99 per cent of patients said the quality of care they received was good’.

“We’ve also provided an extra £2.5m to HIS to continue their improvement work across the NHS.”