THE number of acute hospital beds being lost to delayed discharge in Scotland is now the highest since the pandemic began.
The latest official statistics show that 1,664 beds were occupied by a patient who is clinically ready to leave hospital but unable to be discharged as of Wednesday this week.
The problem mainly affects elderly patients or those with specific vulnerabilities, such as learning disabilities, who require care home places or social care packages to allow them to return home.
In early March 2020, there were 1,612 beds being lost to delayed discharge but the number was slashed to less 600 by April 2020 amid a drive to free up as many beds as possible for Covid patients.
However, delayed discharge has been rising steadily again since May last year.
Earlier this month, NHS Lanarkshire issued a plea to families to “take home” and care for relatives temporarily who were well enough to leave hospital but awaiting a care package as it battled with “exceptionally busy” wards.
Dr Donald Macaskill, CEO of Scottish Care, the umbrella body for independent care providers, said relieving pressure on hospital beds should also focus on preventing avoidable hospital admissions in the first place.
He said: "We need to get much better at supporting people to remain well at home for a lot longer. There are very real challenges within social care, the sector urgently needs more investment and resources, we need to increase workforce recruitment/retention.
"This is in part achieved by paying carers better and enhancing their terms and conditions, but it is also critical that we ensure that care organisations are sustainable and able to survive."
READ MORE: Self-isolation rules eased for care home residents
The figures for delayed discharge come just days after Scotland recorded its worst ever performance for A&E waiting times, a key signal of bed availability beyond the emergency department.
A record 690 patients spent 12 or more hours in A&E during the week ending January 9, despite overall attendance being lower by around 4000 to 5000 patients compared to the pre-pandemic average for the same time time of year.
More than one in eight patients spent more than eight hours in A&E, a figure Dr John Thomson, the vice president in Scotland for the Royal College of Emergency Medicine, described as “shocking”.
Staff are “burnt out and overwhelmed”, he said, adding: “Patient safety is frequently compromised. We know long waiting times increase the risk of death and patient harm.
“The exit block that exists in our Emergency Departments which prevents patients moving in a safe, timely manner to an appropriate ward is worsening, causing even more harm to our patients.”
It came as research published in the BMJ’s Emergency Medicine Journal found that patients who wait over five hours in A&E before admission to a hospital bed are at increased risk of dying from any cause over the subsequent 30 days.
The research, based on outcomes for five million patients in England, also found one extra death for every 82 patients delayed by six to eight hours.
Long-stays in A&E are associated with crowding, delays to vital treatment and a longer hospital stays overall, which in turn increase the risk of a hospital-acquired infection and an increased risk of physiological and psychological de-conditioning which adversely affects recovery.
Derek Prentice, lay member for the RCEM, said the findings underlined the “key importance to patient safety” of the A&E waiting times target, which in Scotland stipulates that 95 per cent of patients should be seen, treated and then admitted or discharged within four hours.
This was last achieved in July 2020 but, pre-Covid, not since 2017.
Meeting it again requires sufficient funding for NHS beds, staff and social care provision, said Mr Prentice, but it “must remain the gold standard”.
In England, where it has been missed since 2015, there are now plans to replace the four-hour measure with a new bundle of targets.
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