By Bill Heaney
Delayed discharge – a poor name for sending people home from hospital – is no straightforward matter, as anyone working on the wards will tell you.
Complications are many since strict rules are in place to ensure that the person going home is first of all well enough for that and that they are able to look after themselves.
To put on their clothes, make a cup of tea and cook a small meal safely.
And very importantly to have access to and be able to consume the medication that has been prescribed for them.
It’s no straightforward matter for nurses to arrange transport, complete the necessary documents and to make sure a member of staff is available to look after the patient during the journey.
A priority is that the patient should be safe and their home should be warm, secure and fit for occupancy.
It’s not surprising then since staffing levels in the Scottish NHS are at crisis point that the numbers of patients stuck in their beds is increasing exponentially.
MSP Jackie Baillie fears for the NHS this winter, as delayed discharge figures soar to record levels.
Scottish Labour has warned that the NHS is “creaking under the weight of SNP failure”, as NHS Greater Glasgow and Clyde faces Scotland’s largest bed blocking crisis.
New data shows that on average, 2,000 patients were stuck in hospital beds every day in Scotland, in August 2024, the highest number since current records began in July 2016.
However, since the statistics are woeful, they are no way as bad as in the past when patients could be waiting for years to go home or to have new accommodation made available to them.
In NHS Greater Glasgow and Clyde, 393 patients were occupying hospital beds beyond the point where they had been cleared for medical discharge in August – the highest figure of all Scotland’s health boards.
The total number of days patients within the board’s hospitals spent awaiting discharge amounted to 12,192 – well above NHS Lothian, Scotland’s next worst performer, on 8,693 days.
Data from Public Health Scotland also shows that the number of patients stuck occupying beds in NHS Greater Glasgow and Clyde increased from 11,911 in January.
Some 64 per cent of delays were attributed to ‘standard’ reasons of health and social care or family arrangements, with just five per cent being down to ‘complex’ issues.
Meanwhile, the total number of days spent in hospital by patients awaiting discharge also reached a record high in August, rising by 11 percent compared to the same month last year, to 62,003.
In total, more than £1.3 billion has been lost due to delayed discharge since the SNP promised to eradicate the practice in February 2015.
It’s not known what the SNP strategy for this was, but it couldn’t have been to keep patients in hospital indefinitely.
The current government strategy, whatever it is, has put unprecedented strain on the Scottish NHS.
The number of planned operations has slumped by 6.5 percent compared to August 2023 and the number of patients waiting more than four hours in A&E rose to 40,794.
The number cancelled at Paisley’s Royal Alexandra Hospital, which serves West Dunbartonshire, in August sat at 40 – 15 cancelled by the patient, up from 33 the previous month.
Dame Jackie Baillie MSP, the Royal Alexandra Hospital and the Scottish Parliament where delayed discharges from hospital are debated interminably.
Jackie Baillie, Scottish Labour’s spokesperson for Health, said: “These figures show the NHS is creaking under the weight of SNP failure even before it enters the turbulent winter months.
“Patients who have been treated want nothing more than to return home, but instead they are stuck in limbo in hospital beds while the corridors of A&E fill up with desperate people waiting to be admitted.
“After 17 years of twiddling its thumbs, the SNP is unprepared for this winter – it must tackle delayed discharge head on before hospital corridors resemble crammed commuter trains.
“A Scottish Labour government will ensure that the NHS is running smoothly so that patients can be treated fast and return home as soon as possible.”
If, like me, you have been waiting an unconscionable time to go into hospital for a procedure a consultant has decided you require then you will be interested to know why this is the case.
Delayed discharge, August 2024
Number of people delayed
- At the August 2024 census, there were 2,009 people delayed. This is the highest number of people delayed since the guidelines were amended in July 2016. Compared to the previous three census points this is greater than July 2024 (1,961), June 2024 (1,991) and May 2024 (1,955).
Length of delay at census point
- The average (median) length of delay for people delayed at the August 2024 census was 28 days. Compared to the previous three months, this is the same as June and July 2024 and slightly longer than May 2024 (27 days).
Average number of beds occupied per day
- In August 2024 the average number of beds occupied per day due to people delayed in hospital was 2,000. This is the highest average number of bed days occupied since the guidelines were amended in July 2016. Compared to the previous three months, this is higher than July 2024 (1,973), June 2024 (1,983) and May 2024 (1,942).
Delayed days in hospital
- In August 2024 there were 62,003 days spent in hospital by people whose discharge was delayed. This is a 11% increase on the number of delayed days in August 2023 (55,709).
Source: https://publichealthscotland.scot/publications/delayed-discharges-in-nhsscotland-monthly/delayed-discharges-in-nhsscotland-monthly-figures-for-august-2024/#section-2
Over £1.3bn lost to delayed discharge since the SNP promised to eradicate the practice in February 2015. https://www.holyrood.com/inside-politics/view,interview-can-shona-robison-heal-nhs-wounds_13015.htm
Monthly A&E, August 2024
Attendances
- There were 133,454 unplanned attendances at A&E in NHSScotland (compared to 131,629 the previous month, and 127,394 monthly average for 2023).
Compliance with the 4-hour A&E access standard
- 92,660 (69.4%) of A&E attendances were seen and resulted in a subsequent admission, transfer or discharge within 4 hours (compared to 91,684 (69.7%) the previous month, and 88,636 (69.6%) monthly average for 2023).
Attendances of over 8 hours
- 13,303 (10.2%) patients spent more than 8 hours in A&E (compared to 13,551 (10.6%) the previous month, and 12,287 (9.9%) monthly average for 2023).
Attendances of over 12 hours
- 5,407 (4.2%) patients spent more than 12 hours in A&E (compared to 5,761 (4.5%) the previous month, and 4,914 (4%) monthly average for 2023).
Cancelled operations, August 2024
During August 2024, there were 23,997 operations planned to take place across NHSScotland. This is 6.5% lower than the number planned a year previously in August 2023 (25,659). In the 12 months from September 2023 to August 2024, there was a 4.7% increase in the number of planned operations compared to the previous 12 months. However, this remains 15.1% lower than those planned to take place in the 12 months from March 2019 to February 2020, just prior to when the pandemic began to severely impact service provision. Source: https://publichealthscotland.scot/publications/cancelled-planned-operations/cancelled-planned-operations-month-ending-31-august-2024
Top picture is of a hospital patient being interviewed by an NHS official.
Back to a warm house where pensioners and the sick can turn up the heating up and stay warm.
Reminds me of George Orwell’s Animal Farm when old Boxer the horse was taken away in the Knacker’s van to be given love and care for his lifetime of service.