Edinburgh health chief says integrated care model needs more time

The head of health and social care in Edinburgh has declared the Scottish Government's integration model of combining local health boards and councils needs 'more time' to achieve the desired results.

Judith Proctor chairs the Edinburgh Integration Joint Board
Judith Proctor chairs the Edinburgh Integration Joint Board

Judith Proctor has been in her post for three months after inheriting services that had been criticised in a damning report by the Care Inspectorate and Healthcare Improvement Scotland. The inspectorate found delivery of key processes had been “unsatisfactory”.

However, the former nurse, who was head of the integration joint board in Aberdeen, told Scotland on Sunday that although there were “teething problems”, she believed care services were improving.

Sign up to our public interest bulletins - get the latest news on the Coronavirus

The integration of health and social care services came about following government legislation under the Public Bodies (Joint Working) Scotland Act of 2014.

The Edinburgh Integration Joint Board, which Proctor chairs, has been at the centre of a delayed discharge crisis – also known as bed-blocking – where people are deemed medically fit to return home from hospital, but are kept in because care support is unavailable. As of May this year, 226 people in Edinburgh have been subject to delayed discharges against a target of 50. Health chiefs allocated a £4.5 million emergency fund in December to tackle the “immediate pressure” of people waiting in hospital to be assessed for a care package.

Proctor said the “big challenge” around delayed discharge was a lack of care in the community to meet the needs of an ageing population. She said: “Delayed discharge is a really good measure of the whole system working. So it’s not the only thing that we have to tackle. We’ve got problems with people waiting for care in the community as well and it’s important to do that well because if you’re cared for well, you’re less likely to need to go into hospital.

“We have lots of organisations providing care at home, but we just don’t have enough and that’s largely linked not to our ability to pay, but the number of staff those organisations are able to recruit.”

Proctor said difficulties with recruitment in the care sector are particularly difficult in Edinburgh, given the city enjoys “full employment”.

She said she believed there was a need to look at the problem across Scotland and examine how to “really value” care vacancies.

Proctor added: “We’re thinking as a partnership about how we can support organisations. We’re looking at how we might attract more care providers to Edinburgh and what we can do to help them reward their staff.

“Sometimes it’s about paying them more – not always. It could be other things that make it a good job, like them feeling part of our team or them being able to work in a very local patch rather than having to zigzag across the city. So we’re doing detailed work at the moment with those provider organisations to see what we can do as a health and social care partnership to attract more people to those jobs.”

The Edinburgh Integration Joint Board is working on a series of measures aimed at reducing the burden on the city’s GPs, with a multi-disciplinary approach moving towards greater responsibility being given to pharmacists and other health care professionals.

Proctor said since the Care Inspectorate report “solid planning” was in place and she was confident this would improve health and social care services in Edinburgh.