Bed blocking figures illustrate need for care investment

CaptureRecent projections released by the National Records of Scotland reinforced the message that our health services will come under increasing strain as our population ages.

In its latest analysis of Scotland’s population, the NRS predicted that the number of people aged 65 and over living alone could increase by more than a half in the next 25 years.  Meanwhile, the number of Scots living to 85 and over and living alone is predicted to increase by 161%.

The reference to living alone is not an insignificant point with loneliness and isolation having a notable impact on general health among older people.  The Herald’s Time for Action campaign cites research suggesting that the majority of doctors report having patients who attend on a daily basis due to loneliness.

The population projections are a double edged sword – an indicator of how advances in health care are helping us live longer lives and a wake up call to the realities of the capacity pressures that this will bring.

In NHS Lothians, addressing these capacity pressures is already a pressing issue, a fact well demonstrated by figures on bed blocking.  Bed blocking occurs when a patient is medically cleared for discharge but because of the lack of appropriate care support, is forced to remain in hospital.

In the year to March 2014, almost 120,000 bed days were lost across NHS Lothian due to bed blocking – more than a fifth of the national total.  To tie this back to the issue of ageing, consistently around 70% of these lost bed days relate to patients aged 75 and over.

Addressing capacity through the whole system is vital – in the latest census period  more than half of delayed discharges in the Lothians were due to issues with care home place availability.  I have raised the issue of provision with the Council to ask what action it is taking to address demand.   The long term impact of the council tax freeze and the increasing numbers of people needing care means that funding for council provided care is under huge pressure.

I raised the issue of the cost to the NHS of bed blocking with the Health Secretary in Parliament during Ministerial Question Time.  He confirmed that the average weekly cost of keeping a patient in acute hospital was around £4,000, compared to £1,800 in a community hospital, £600 in a nursing home and £300 for home care but ducked my request for a breakdown of costs by NHS board across the country.

I’ve written before about the acute pressures on local government services due to SNP funding decisions so I’ve submitted written questions to get a clarification of how much money could be freed up to fund care services and for details of how much the Scottish Government intends to save by tackling bed blocking and where the savings will be spent.  However, the benefits of effectively tackling this issue are not solely financial.  the prize is the possibility of vastly improved health outcomes for our elderly people.