Warning care homes may be unable to provide extra NHS beds

The First Minister said Scotland’s hospitals were “almost completely full” - with 95 per cent occupancy as of last Wednesday against a recommended safe threshold of 85% - but that 1,700 beds were being taken up by patients who are medically fit to leave.

Full details of the plan will be outlined today by Health Secretary Humza Yousaf, but Ms Sturgeon said health and social care partnerships will get immediate extra funding “to support the booking of additional care home beds for patients to be discharged to while their care packages are being finalised”.

She added: “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.”

ANALYSIS: 'Unnecessary attendances'? That's not the problem facing our A&Es 

Medics have warned that a lack of available beds on wards, which has been exacerbated by surges in flu and Covid admissions, is leading to dangerous levels of overcrowding in A&E and ambulance handover delays.

By the end of December, one in 10 patients brought to hospital by ambulance spent over three hours waiting to be offloaded.

Some care homes already provide temporary “step down” beds for patients who are completing rehabilitation, waiting for a permanent care home place, or for a social care package in their own home.

Rates of flu in the community were the highest in 12 years in December, while the number of people admitted to hospital with flu also rose sharply. By the end of December an estimated one in 25 people in Scotland also had Covid (Image: PHS)

Scottish Care, which represents private care providers, said social workers and clinicians have been working with care homes in the last few weeks to “maximise” their use, but cautioned that it is only possible in premises “where there are sufficient nursing and care staff to resource these interim care beds”.

In a statement, it added: “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.”

Ms Sturgeon said there were “no easy solutions” to the current crisis engulfing the NHS, which she described as the “most difficult winter ever”.

READ MORE: Medics warn overcrowded A&E conditions like 'playing Russian roulette' with patients' lives 

However, critics have accused the Scottish Government of failing to adequately prepare for the spike in respiratory illnesses, which has seen flu rates hit their highest levels in more than a decade.

The Royal College of Emergency Medicine also says that, even without the pandemic, NHS Scotland needs 1000 extra beds to cope with demand.

Ms Sturgeon said guidance will also be issued to health boards by the Scottish Government this week “making clear that they can and should take steps to prioritise and protect critical and lifesaving care if that is deemed necessary”.

This could include relocating staff “to areas of greatest pressure” and “opening or procuring additional capacity” for a short period, said the First Minister.

Nicola Sturgeon speaking at an emergency briefing on the NHS winter crisis at St Andrews House, Edinburgh, on January 9 (Image: PA)

It comes after doctors in some health board areas, including Glasgow, called on NHS bosses to declare a Covid-style major incident in order to maximise frontline resources.

NHS Borders has already paused all non-urgent elective care due to bed shortages, and several health boards suspended elective orthopaedic work in December until the end of January.

Speaking during the emergency briefing on the NHS at St Andrews House, the First Minister said GP practices will also be encouraged to open at weekends in an effort to reduce attendances at A&E - a policy already adopted in NHS Lanarkshire - with additional NHS 24 call handlers also being recruited over the coming weeks to help patients manage medical problems over the phone.

Ms Sturgeon also said ambulance crews were “preventing hundreds of people every week having to go to hospital” by seeing and treating them at the scene instead.

READ MORE: Patients 'died in ambulances' amid 'horrific' handover delays at A&E

More than half of cases attended over the festive period saw patients treated at the scene without going to hospital.

Before the pandemic, more than 60% of callouts resulted in a patient being taken to hospital.

“That’s better for patients, but it also reduces pressure on hospitals,” said Ms Sturgeon.

However, she added that this also meant that those who do end up in hospital “tend to be sicker with more complex needs”.

Dr John-Paul Loughrey, vice-president for the Royal College of Emergency Medicine in Scotland, welcomed efforts to free up beds, but stressed that the issue of A&E attendances was overstated.

He said: “The problem right now isn’t a deluge of patients who should be seen in other settings - the major problem is exit block and access to care for those sick patients who need ambulances and hospital admission.

“A patient who comes to the ED with a sore ear might have a legitimate concern, but those patients can be managed relatively quickly.

“The principle of making sure patients are getting care in ways that avoid ED attendance where possible is helpful, but it won’t do anything to address the current crisis in ambulance delays and overwhelmed and overcrowded EDs.”

Dr Iain Kennedy, chair of BMA Scotland, said the NHS is not sustainable with current staffing and financial resources.

He added: “We have to get serious and have a proper long term discussion about the future of our health service rather than just struggle to survive from crisis to crisis as the NHS and its staff endure the kind of perpetual pressures which in the past were reserved for the worst of winter.”