Nicola Sturgeon has insisted there was “no contradiction” in asking hospitals and health bosses to reduce the number of patients awaiting delayed discharge while avoiding spreading Covid-19 into care homes.
The issue had been raised at the Scottish Government’s daily coronavirus briefing and followed a story in the Sunday Post which published a letter from health secretary Jeane Freeman congratulating health bosses for hitting delayed discharge targets.
The Scottish Government had been accused of putting “enormous pressure” on health boards to move elderly patients out of hospitals and into care homes to free up beds for expected incoming Covid-19 patients.
However the First Minister rejected out of hand that the policy had led to the issues seen in care homes where more than 2,000 people died from Covid-19 and several were transferred to care homes from hospital after testing positive for the virus.
She said: "On the Sunday Post issue there is no contradiction whatsoever between the policy position of reducing delayed discharges and the position that was encapsulated in guidance in March this year for any individual who was being discharged from hospital into a care home to undergo a clinical risk assessment.
"On the general policy of reducing delayed discharge, there can’t be anybody who hasn’t been aware for years and years and years that it is an objective, not just of the Scottish Government but of government’s across the world to not have older people who don’t have a medical need to be in hospital, in hospital.
"It is seen as a good thing to get them discharged from hospital into more appropriate care settings.
"The idea that it comes to news to anybody that there was a policy objective on the part of the Scottish Government to reduce delayed discharge I think is a bit odd.”
The First Minister added that the policy to reduce delayed discharge and the policy of ensuring there were individual risk assessments for those being moved into care homes were “perfectly consistent”.
She said: "At the start of this pandemic we couldn’t have been clearer, because the health secretary announced it to parliament that we were seeking to accelerate that process in reducing delayed discharge for all the reasons that we always wanted to reduce delayed discharge and usually opposition parties are criticising the government for not doing it quickly enough, but for the added reasons back then that we knew we had to have capacity in our hospitals to deal with Covid and with Covid patients potentially coming into hospital, it was even less of an appropriate place for older people to be.
"That policy position I don’t think should be news to anybody but at that point there was also guidance put in place that in individual cases clinical risk assessment should be done to make sure that the discharge was appropriate in the individual cases.
“These two things are perfectly consistent with each other as the health secretary has set out in parliament and indeed at these briefings on many occasions previously.”
The letter which sparked the story was written by Jeane Freeman and Cllr Stuart Currie, the COSLA health and social care spokesman.
It said: “The requests from Malcolm Wright, Director General, Health and Social Care, during March to reduce delayed discharges by 900 by the end of April must have seemed very challenging when first made.
“We were very pleased to note that that goal was passed on April 8, when delays had reduced overall by 920 since the beginning of March – a remarkable national reduction overall of 57%. Please pass on our thanks to everyone involved.”
“Of course, it remains of paramount importance not only that we free up hospital beds to help manage our Covid-19 response but that now, as always, we are focused on ensuring people have access to the care that is most appropriate to their needs and wellbeing.”