four ageing city hospitals will be knocked down to make way for new care villages under radical plans to plug a crippling gap in community care.
The Royal Victoria, Liberton, Corstorphine and Astley Ainslie hospitals all face demolition as part of the blueprint to stop bed blocking and revolutionise care in the community.
Soaring demand on services caused by an ageing population has left the Capital needing an additional 5000 hours of home care every year, putting additional strain on already-stretched hospitals.
Speaking exclusively to the Evening News, NHS Lothian chief executive Tim Davison said: “We don’t have enough social care capacity in Edinburgh, we need an additional 5000 hours of home care. Whether that is helping with eating and drinking, dealing with hygiene, supervising medication – basic social care – we are working with the council to do that.”
At present NHS Lothian struggles to provide quality care in its older buildings and believes the services would be better suited – and provided more cost effectively – in new developments.
The mixture of community hospital beds, care home facilities and sheltered housing were revealed in the News last week as part of the health board’s ten-year vision.
NHS Lothian bosses are now looking to draw up firm plans with the city council, which has already pledged £2 million from its reserves to help tackle the shortage.
Buildings would be demolished and “brownfield sites” created with purpose-built facilities in their place at Liberton and the Royal Victoria.
NHS Lothian must make savings of £40m a year over the next decade – to be reinvested into new facilities like these – if it is to tackle the problems caused by increased needs and squeezed budgets.
It is hoped the radical proposals will save money in the long term with hospital care costing an average £1100 per patient, per week, compared with between £250 to £580 a week for means-tested care in the community.
Mr Davison, the body’s chief executive, said the care villages were vital to cope with growing demand.
He said population growth meant the current system of healthcare was outdated.
The lack of care places – estimated to be 60 short in Edinburgh alone – have been causing increasing cases of bed blocking at Liberton and the Royal Victoria. He hopes this will diminish if the care village plan gets the go-ahead.
He said: “We want to create this concept of a care village that would be essentially social care with a range of care home facilities.
“They would be purpose-built, single room, ground-floor facilities but also with the possibility of supported living with everything needed like ramps, wide door frames, disabled access bathrooms.
“The aim would be to create facilities that would be able to be utilised by the older and frail population and also be dementia-friendly.
“At the moment the financial challenge is how we get more for less. We need a greater volume of care because of the growing ageing population, at a higher quality and at less cost per patient.
“It is costing £1100 a week to provide a patient with accommodation in a relatively poor quality hospital that is not as good as a purpose-built care home which costs far less.
“Savings made could either go towards the £40m a year we have to save or towards providing the higher volume of care we know is needed.”
The old Royal Victoria Hospital was previously shut in August 2012 and earmarked for sale and redevelopment.
But increasing emergency admissions, the growing problem of bed blocking and the norovirus winter vomiting bug meant it was reopened to the public months later as the ERI struggled to cope with demand.
It now has an average of 50 to 70 delayed discharges – where patients await onward care before they are able to leave, causing a backlog. The number of older people supported by health and social care stood at 11,065 in January – an increase of almost ten per cent in 19 months.
Mr Davison said plans were at an early stage and it would be 18 to 24 months before they could even consider “moving a patient”. The strategy is only just out to public consultation and would be subject to planning permission and funding bids.
City council health leader Ricky Henderson said he was in regular meetings with NHS bosses about escalating public care needs.
He said there were already “step-down beds” in place so patients that no longer require hospital care can be temporarily put in care home settings to continue recuperation, while deciding on the best course of action. He said: “The idea logically follows to have a care village with a variety of services on site and the ability to provide a service to people regardless of what their level of need is.
“We tend to live longer with more complex health conditions and I think society is still trying to get to grips with what we need to put in place across a whole range of services to make sure people can live as independently for as long as possible.”
Margaret Watt, of the Scottish Patients Association, said she had been championing care villages for “years”.
She said: “It will be great if we have a wee village with all the care people need, and a shop or two, and create a real sense of community again.
“I do think it is the way to goand cheaper in the long run than people getting stuck in hospitals.”
A Scottish Government spokesperson said: “We want to ensure that all older people receive quality and compassionate care that protects their dignity and independence on every occasion and in any care setting.
“That is why our health service is evolving to meets the demands of our changing population. It has long been our policy to care for older people in their own homes – or in homely settings in the community – wherever possible. By integrating health and social care we will improve care for people in communities.”
ELDERLY CHARITY BACKS INTEGRATED PROPOSALS
RECENT research from Age Scotland, commissioned to understand more about people’s attitudes towards ageing and living longer, shows that more than three-quarters of adults in Scotland are looking forward to living longer, peaking at more than eight in ten for the 65-74 age group.
Scotland’s population is ageing, with the those aged 65 and over expected to reach 25 per cent by 2035.
With that in mind, a spokeswoman for Age Concern backed the ambitious plans to better integrate care.
She said: “In the future, social care will have to make greater use of step-up and step-down facilities if we want to achieve our ambition of enabling more older people to live at home, or in homely settings, for longer, especially as the population ages.
“Co-locating care with health services might make it easier to combine the two in an effective and economical way. More modern facilities also offer the opportunity to provide greater flexibility and more personalisation through better design.
“A campus approach could be a good option for some.”