More than 67,000 bed days in NHS Lanarkshire were lost to delayed discharge during 2022-23, as figures across Scotland reached their highest-ever rate.
Patients spent a combined total of 67,388 extra days in the area’s hospitals while awaiting arrangements for ongoing social care – and Central Scotland politician Monica Lennon says the issue is “piling pressure on hospitals” and estimates the local cost at almost £20 million.
Health board officials say that last year was “very challenging” but that “significant improvements” have since been made through the Operation Flow initiative which has reduced hospital occupancy and length of stay, while new teams supporting early discharge and wraparound care have been established.
New figures from Public Health Scotland (PHS) for the 12 months to March 31 this year show that NHS Lanarkshire’s number of delayed discharge days for adults aged 18+ was the fourth-highest of Scotland’s 14 health boards – with the nationwide total of 661,705 days being “the highest annual figure reported” and an increase of 22 per cent on the previous year.
The report noted that 82 per cent of the delays in the local health board were caused by awaiting completion of care arrangements, while the total of 16 per cent for “complex delays” was the second-lowest in the country.
Lanarkshire residents, including those treated elsewhere outside the area during the year, spent a combined total of 79,771 delayed discharge days in hospital – with South Lanarkshire’s total of 41,970 being the fourth-highest of the country’s 32 local authorities and North Lanarkshire’s 37,801 days ranking seventh.
Costs are no longer included in the PHS report following the Covid pandemic as “detailed cost data could not be submitted by NHS boards” and using previous years’ figures is not considered appropriate as “the impact of Covid-19 means expenditure would likely be underestimated”.
The last published cost of delayed discharge was £262 per day in 2019-20 – and Scottish Labour say that using that sum with an adjustment for inflation means the cost to NHS Lanarkshire last year was an “eye-watering” £19.6m.
Ms Lennon MSP said: “Delayed discharge in Lanarkshire is piling pressure on our hospitals and threatening patients’ recovery; our NHS is at breaking point and every penny matters, and it is a scandal that NHS Lanarkshire has been forced to foot a £19,684,035 bill for SNP incompetence.
“Social care in Lanarkshire is crying out for help, but the SNP’s botched national care service plans will do nothing but centralise local services.
“The Scottish Government must support social care in Lanarkshire and increase pay for the sector’s dedicated workers so no-one is left languishing in hospital waiting for a care package.”
NHS Lanarkshire officials say that their work to improve patient pathways during the past year has reduced the number and duration of hospital stays, and that improvements including seven-day use of discharge lounges and new dedicated teams have made an impact.
Professor Soumen Sengupta, chief officer of South Lanarkshire’s health and social care partnership (HSCP), told Lanarkshire Live: “The last year, and the winter in particular, was very challenging for our services, patients and staff; we developed a plan to help us redesign and rebuild our service to be more resilient and for Lanarkshire to be a good place to be cared for.
“We launched whole-system improvement programme Operation Flow, which included the very successful short-term firebreak in February and March, and saw significant improvement.
“[This included] improved opportunities to support people to remain well at home, reduction in hospital occupancy, length of stay and delayed discharges, improvement in our four-hour A&E access and an important reduction in ambulance waits and eight- and 12-hour delays.
“Since then, a huge amount of work has been underway to build the second phase of this work with a focus on key performance improvements, including reducing lengths of stay and improving discharge without delay.
“One of the key steps includes opening discharge lounges seven days a week to support discharge as early as possible; and the new program is focused at improving the full patient pathway from avoiding hospital admission through to discharge and beyond.”
North Lanarkshire counterpart Ross McGuffie added that new teams in both partnerships have supported “in excess of 1000 early discharges home with wraparound support to allow assessments to take place in people’s own homes”, and said: “The HSCPs have also undertaken considerable recruitment campaigns to increase social care capacity with the aim of reducing admissions and supporting timely discharge.”
A Scottish Government spokesperson said: “We recognise the value of adult social care to all who require additional support to live independently at home or in the community, with recent figures showing the number of people waiting for an assessment has decreased in Lanarkshire.
“We increased social care support from home funding and delivered pay rises to help deal with the consequences of reduced staffing because of Brexit, the pandemic, and rising costs of energy and inflation; we have also put in place the delayed discharge and hospital occupancy action plan to support health boards to create the necessary capacity to deal with emerging pressures.
“We will continue to work with health boards and with health and social care partnerships as they introduce these actions and begin to prepare for winter.”
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