Yousaf: 300 extra care home beds to ease NHS pressure

This is in addition to the 600 interim care home beds already used to provide "step down" care for patients leaving hospital who require rehabilitation, are awaiting places in their preferred care home, or need a social care package. 

Care homes will be paid 25 per cent more than the standard rate for council-funded residents to accommodate these patients, said Mr Yousaf, who said the NHS was battling its "single most challenging winter" ever.

READ MORE: Care homes staff shortages and Covid outbreaks mean even available beds 'cannot be used' for NHS

He conceded that the plan could see patients moved into homes which were not their family's "first or second choice", but said this was preferable to spending too long in acute care settings. 

He said: "This is an extremis, time-limited measure to help us with the current capacity issues that we face. 

"The additional funding is intended to meet the increased costs of utilising these beds for a short period of time. 

"With partners, we've managed to identify around 300 interim beds that are available. This is in addition to the 600 interim beds that are already helping patients in the system. 

"This support is intended to be used as an additional tool that health and social care partnerships can deploy during the current situation to maximise capacity in our hospitals. 

"We will work with partners to utilise every bed possible. These interim beds may not be a family's first, or indeed second, choice for their relative, but I hope families agree that in the current circumstances this is about making the best possible choice for those in our care."

READ MORE: A&E gridlock years in the making - and it's not about 'unnecessary attendances'

It comes amid warnings from operators that even where beds are available in care homes, they could struggle to open them up to the NHS due to rising absence rates among "exhausted and tired" staff or outbreaks of viral illness such as flu and Covid which require them to close to new admissions. 

Donald MacAskill, chief executive of Scottish Care - which represents providers - said one care home owner had told him that that 60% of his staff were off through a combination of illness and childcare needs due to school strikes.

Others worry that - even with the funding boost - they will unable to attract enough extra staff on short-term contracts to safely accommodate additional residents.

There are currently more than 1,700 people in hospital who are experiencing 'delayed discharge' - meaning they are continuing to occupy beds for days or weeks after they are ready to leave hospital. 

The problem is leading to A&E gridlock and severe ambulance handover delays because hospitals are unable to find beds for patients requiring an urgent admission. 

On Monday, First Minister Nicola Sturgeon warned that hospitals were "almost completely full" with 95% occupancy versus the 85% maximum recommended for safe care. 

The latest figures for the week to January 1 show that more than 2,500 patients spent over 12 hours in Scotland's emergency departments - a record number and equivalent to one in 10 of all those who attended. 

During the same week, one in 10 patients arriving at A&E departments by ambulance had to wait over three hours to be offloaded - meaning vehicles were also unable to respond to 999 callouts.

READ MORE: Warning chaotic A&E conditions 'like Russian roulette' 

Doctors have warned that the situation is unsafe, and leading to avoidable deaths. 

During the final two weeks of 2022, the number of deaths recorded in Scotland was 16 per cent higher than normal for the time of year.

According to the National Records of Scotland, there were 392 deaths more than expected when compared to the five-year average (2016-19 plus 2021 - 2020 is excluded). 

Separate figures from Public Health Scotland also show that, by November, delayed discharge levels had hit a new record, with an average of 1,950 beds each day being occupied by a patient who was medically fit to leave hospital - equivalent to 14% of NHS beds. 

On average, patients affected by delayed discharge are spending an 23 days in hospital. 

The number of beds lost to delayed discharge has been exceeding pre-pandemic levels now for a full year (Image: PHS)

Earlier, Mr Yousaf told Holyrood's Health and Social Care Committee that it would be unaffordable to increase hourly pay for those working in social care to £15-an-hour - as Labour has called for. 

The Scottish Government has budgeted around £100 million to increase care staff wages from £10.50 to £10.90 per hour in 2023/24. 

Even increasing pay for care staff to £12 an hour would cost the Scottish Government "hundreds of millions", Mr Yousaf added.

He insisted he could not "take the cost of £12 an hour off the NHS and put that into social care, because it would have a very significantly detrimental impact on the NHS at this stage".

Colin Poolman, director for the Royal College of Nursing Scotland (RCN) Scotland, said tackling delayed discharge long-term would depend on reversing "serious workforce shortages" in the community. 

He said: “District nursing services play a key role in supporting people to return home from hospital, and in preventing hospitals admissions in the first place, but the vacancy rate for district nursing has reached 16%. Meanwhile 60% of care services that employ nurses report vacancies.

“Without investment in staff, providing more facilities - whether it’s more beds in care homes or hospitals - won’t tackle this problem.”

READ MORE: 'It's falling apart' - Scots GPs on their fears for the future of general practice 

This was echoed by Dr Andrew Buist, chair of the BMA's Scottish GP Committee. 

Mr Buist said: "We have significantly underinvested in community care and fallen to the pressure to adopt new high-tech treatments for a few at the expense of getting the absolute basics of care right for the majority.

"What we need is to bring resources ‘upstream’, closer to where patients live.

"There is good evidence with more district nurses, health visitors and GPs we can prevent more activity ending up in hospital and with better support packages for paid carers we can address the delayed discharge problem that is holding up admission from A&E."

Jackie Baillie, Scottish Labour's health spokeswoman, said: “The Health Secretary has been warned about this crisis for well over a year, and he has failed to listen and act on solutions.

“This government failed to end delayed discharge, something they promised to do in 2015 and eight years on, it’s at record levels."