Edinburgh health leaders to roll out 'home first' care strategy to end bed blocking
HEALTH bosses have approved plans to accelerate caring for patients at home in a bid to reduce the amount of bed-blocking in the Capital’s hospitals and improve the support people receive in their own community.
The number of lost days due to delayed discharge increased in Edinburgh from 72,914 to 81,071 in 18/19- costing £20.1m last year. In 2018/19, 86 people died in hospitals across the Lothians while they were waiting to be discharged – the highest number in Scotland. But between April 2018 and August 2019, Edinburgh has recorded a reduction of nearly 2,000 occupied bed days attributed to delays.
The Edinburgh Integration Joint Board (IJB), made up of Edinburgh City Council and NHS Lothian representatives, approved rolling out the ‘home first’ approach – which will shift health and social care systems to provide greater support for people in their own or familiar surroundings.
Health chiefs will use £600,000 freed up from changes to NHS Lothian’s bed-base towards community services to “roll out home first across the city with an initial focus on north Edinburgh”.
The model has already been introduced at the Western General Hospital, where a new post of home first navigator has been filled to support medical professionals to think differently and explore possible alternatives for patients to an extended hospital stay, tailored to patients’ individual needs.
Chairman of the Edinburgh IJB, Angus McCann, said: “We have made significant progress getting people home safely, quickly and in reducing the number of bed days lost. While this improvement is very positive, we’ve reached a stage where a new approach is needed – one which prioritises a patient’s options and choices, improves their chances of living independently, supports really meaningful collaboration between health workers and communities and reduces waiting times even further.
“Research tells us that the earlier people get out of hospital, the less likely they are to end up back on a ward. Indeed, people in Edinburgh tell us that they don’t want to stay in hospital any longer than is necessary. Our shift to support a community focused model of care, through the expansion of our home first model, will help us care for more people in their own homes or homely settings. It will see us step up the care we provide locally and support care workers to have the confidence to admit people to hospital only when it is the best option for them.”
Tom Cowan, head of operations at the Edinburgh Health and Social Care Partnership, told the board that the policy is “one of the cornerstones” of the direction of travel for health services in the city.
He added: “It exists so where possible, individuals avoid being in hospital unless the absolutely need to.
“The home first approach and the investment we are looking at here would enable us to reach that next level of trajectory. You need a systemic chance in how you do your business.”
Conservative Lothian MSP Miles Briggs welcomed the new approach, but warned more challenged lie ahead for the city.
He said: “It is vital that we see the shift towards more care in the community which is definitely the way forward. It is clear that Edinburgh faces many additional and increasing challenges and to meet these we need to see innovative and new models of care developed.
“With Edinburgh facing the fastest growing elderly population in Scotland it is crucial that we see action and resources invested now to plan ahead and put in place the care to future proof our social care in Edinburgh and across Lothian.”