NHS Scotland crisis: Healthcare bosses cast doubt on NHS rescue plans announced by Nicola Sturgeon

Leading nursing and care sector bosses have cast serious doubt on the Scottish Government’s key pledges to combat ‘bed blocking’ and ease the “exceptional” pressures on the NHS, citing “an exhausted and tired workforce” and thousands of healthcare vacancies.

Nicola Sturgeon said she was “very sorry” to those not receiving the quality of care they deserved on the NHS as she conceded “the reality is hospitals right now are currently almost full”.

The First Minister outlined her Government’s plans to ease the “unprecedented pressures” on Scotland’s NHS by recruiting more staff for the NHS24 call service and funding extra beds in care homes to enable ‘bed blocking’ patients to be discharged from hospital and into community care.

But health chiefs in care and nursing stressed the solution was not as simple as increasing funds, citing severe staffing shortages.

First Minister Nicola Sturgeon at the St Andrew's House briefing. Picture: Wattie Cheung

Scottish Care chief executive Donald Macaskill said the care home sector in Scotland had previously been used by NHS health boards as “step down” locations, which allow care and support to be delivered to individuals who are fit to be discharged from hospital, but cannot be released due to a lack of availability in community care.

But he said these “interim” care beds were not available in every home”, adding “It should be stressed that the use of care homes in this way is only possible in those areas where there are sufficient nursing and care staff to resource these interim care beds.

“Sadly, like the whole health and social care system, many care homes are at this time experiencing an exhausted and tired workforce and higher than usual absence levels due to the range of winter respiratory viruses including a sharp rise in Covid-19.

“It should also be noted that some care homes even where there are staff and beds available are not able to respond because they are actively fighting a Covid outbreak.”

Royal College of Nursing (RCN) Scotland director Colin Poolman said staff retention and recruitment was a key stumbling block to the Government’s plans.

“The First Minister highlighted how difficult things are in our health and care services and this is the daily reality for our members and those they're caring for,” he said.

“Patients are being put at risk and the impact of working under this level of pressure every day cannot be overstated. Scotland’s nursing workforce crisis is at the heart of these challenges.

“We simply don’t have the nursing workforce we need, and it is patients and families who are suffering.

“Our previous warnings have not been listened to. Thousands of nursing posts are vacant, we’re not seeing the numbers we need applying to study nursing and many experienced staff are so worn down they are opting to leave the profession.

“The Scottish Government and employers must do more to value and retain our existing experienced nursing workforce and to attract the workforce of the future – fair pay is a fundamental part of this.”

Speaking at a press conference at St Andrew’s House flanked by health secretary Humza Yousaf and reminiscent of the weekly briefings delivered during the Covid pandemic, Ms Sturgeon said hospitals across Scotland surpassed 95 per cent capacity on January 4, compared to pre-pandemic levels of 87 per cent.

The First Minister said “extraordinary levels of winter flu” and rising Strep A cases were to blame, alongside delayed discharges – where a patient is ready to leave hospital, but cannot because the necessary care package or accommodation is not available.

An estimated 1,700 people are still in hospital, but are ready for discharge, she said.

Dr Iain Kennedy, chair of BMA Scotland, stressed 95 per cent bed occupancy was “just not sustainable”.

Pressures on Scotland’s healthcare system have become so severe, particularly in primary care, the Royal College of Emergency Medicine last week estimated an extra 50 Scots a week were dying needlessly due to delays in treatment and poor quality of care.

When Ms Sturgeon was asked by The Scotsman if she took responsibility for those excess deaths, and if she had anything to say to the families of those affected, the First Minister said: “I have very often, and will readily say again, I’m very sorry to anybody who doesn’t get the speed of care, or the quality of care from the NHS all of us want to see them get.

“The vast majority of people do get speedy, high quality care. I take responsibility for everything that happens that is the responsibility of the Scottish Government. That is the nature of my job.”

Ms Sturgeon said “immediate extra funding” would be provided to health and social care partnerships to support the booking of additional care home beds for patients to be discharged to while they await an appropriate care package. “That will benefit patients, I think it’s important to note that first and foremost, but it will also free up much-needed capacity in hospitals,” she said.

Additional staff for the NHS 24 service is also set to increase in the coming weeks after workforce numbers were increased prior to the festive period to reduce the need for hospital visits. Mr Yousaf is expected to update the Scottish Parliament this afternoon on the new measures in a statement.

Ms Sturgeon said the Government did not wish to take direct ministerial control of health boards under emergency powers available to the Government in the wake of the Covid pandemic. She said she wanted health boards to retain flexibility to respond to local pressures and that declaring a “critical incident” would be “simply putting different labels on the problems”.

Scottish Conservative shadow health secretary Dr Sandesh Gulhane said: “This press conference bore all the hallmarks of a government that was missing in action over the holiday period being seen, belatedly, to respond to the enormous crisis in our NHS.

“Nicola Sturgeon was full of sympathy for let-down patients and warm words for over-stretched staff – but there were precious few concrete measures to turn things around. This PR exercise was too little, too late.

“She and Humza Yousaf remain in denial of the fact that they’ve been caught off guard by the extent of the demands on the NHS this winter, despite the fact that they were warned of what was looming well in advance.

“While she recognised that most of the capacity problems stem from the SNP’s failure to tackle delayed discharge, she refuses to drop her reckless plans for a wasteful, centralised National Care Service.

“Astonishingly, she also claimed Humza Yousaf is ‘doing a very good job’ as health secretary. This beggars belief when he has lost the confidence of NHS staff and his flimsy recovery plan has been found desperately wanting.””

Scottish Labour health spokesperson Jackie Baillie said: “Staff are exhausted, services are at breaking point and patients are dying – but the First Minister spent more time making excuses than setting out solutions.

“Faced with the most difficult winter in NHS history, the SNP are deflecting blame and rehashing the same old promises they have been making for years. These changes will barely scratch the surface of this deadly crisis and fail to grapple with the major structural problems clinicians are raising.

“Instead of quietly sidelining her own health secretary, Nicola Sturgeon needs to sack Humza Yousaf and appoint someone up to the job. We can’t keep teetering on the brink of disaster – we need action now to support health and social care workers, drive down waiting lists, invest in social care, and tackle delayed discharge for good.”