Public spending watchdog Audit Scotland warned in October that the NHS would remain “financially unsustainable” without greater integreation of health and social care.
For far too long, too many people have been falling through bureaucratic cracks in the system of health and social care.
While the 2014 Public Bodies Joint Working (Scotland) Act sought to integrate these two services, progress to date has been limited. For example, in September it was revealed that there had been 124,000 delayed-discharge days in NHS Lothian – days when a patient stayed in a hospital bed despite being well enough to leave. One of the main reasons for this regrettable situation is the patient needs some form of care at home that has not been arranged.
This unacceptable inefficiency is a drain on NHS resources but also a blight on the lives of the people concerned. Who among us wants to be stuck in a hospital when we could be at home?
And for anyone doubting the importance and scale of the issue, public spending watchdog Audit Scotland warned that the NHS in Scotland would remain “financially unsustainable” without greater focus on the integration of health and social care in a report in October.
Scotland has a plan
Therefore the Scottish Government’s “integrated health and social care workforce plan” – said to be the first of its kind in the UK – is a welcome attempt to bridge the current gap. As part of the plan, the Scottish Government aims to recruit 375 district nurses by 2024 to enable the number of people receiving care at home to increase, thereby freeing up hospital resources.
The number of unfilled vacancies in the health service should add a caveat to that goal as should Brexit, with concerns about the ability to recruit EU nationals, who currently make up 7.3 per cent of registered nurses in Scotland.
But, at least steps are being taken and Scotland has a plan – although it does come at least a year late. As Scottish Conservatives’ health spokesman Miles Briggs pointed out “perhaps if the Nationalists had acted sooner, we wouldn’t be facing this current crisis”.
A year-and-a-half on from her appointment, Health Secretary Jeane Freeman is still relatively new in the job. Fixing the NHS’s many problems requires careful consideration and is not to be rushed. However, last month the Scotsman warned Freeman would not last long in the post unless she was urgently exploring ways to improve the NHS. Time will tell whether this is a step forward or an exercise in papering over the cracks.