Anger as crowded hospitals forced to ‘board’ patients

Alex Neil
Alex Neil
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More than 50 patients a day are being treated in inappropriate areas in Lothian hospitals because of pressure over beds, new figures show.

The practice of “boarding” sees patients put in areas that are not best-suited to their needs because there is no room in the wards they should be in.

It has become common in the Royal Infirmary, Western General Hospital and St John’s Hospital, with the latest figures showing that patients spent the equivalent of 1522 days in the wrong areas in just one month.

Health Secretary Alex Neil, pictured, has stepped in, and announced a plan to address the unnecessary patient moves, which can cause health to deteriorate and mean they can be far away from specialist care if something goes wrong.

Dr Jean Turner, director of the Scotland Patients Association, said boarding had become a “huge problem”, largely because hospitals like the Royal Infirmary were too small.

She said: “People are being taken into hospital and can end up in three or four different places. That’s no good for patients or the doctors and nurses looking after them.

“If patients are in the same place being seen by the same doctors rather than being shifted around different wards things are picked up which otherwise might have been missed. Continuity of care is extremely important.”

In September, patients spent a combined 564 days being boarded in the Royal Infirmary, which has since come under increasing strain due to winter pressure. And at the Western General Hospital, patients spent 438 days being boarded over the four weeks and at St John’s in Livingston, patients were in the wrong areas for a combined 520 days.

Evidence suggests boarding can have a serious impact on patients, with the practice increasing the length of hospital stays and the chances of developing complications. It is also believed that boarded patients have higher mortality rates than those who are not.

Under the Royal College of Physicians of Edinburgh (RCPE) and NHS Scotland plan, to be rolled out throughout Scottish hospitals, nine areas will be addressed to reduce boarding. They include ensuring there is an adequate number of beds, that correct levels of consultants and nurses are in post, having patients reviewed daily and reducing delayed 

A £3 million Winter Surge Fund to alleviate pressure on the NHS has also been set up, to be distributed nationwide.

Dr Neil Dewhurst, President of the RCPE, said the body had become “deeply concerned” about boarding. He added: “This results in poorer quality patient care and increases the pressure on medical teams.”

Dr David Farquharson, NHS Lothian’s medical director, said that work was already well under way to address boarding.

He said: “We assess our figures on a daily basis and have put in place a number of measures to tackle the issue, including opening additional wards at the Royal Victoria Hospital, recruiting extra medical staff and introducing a new patient assessment system at the Royal Infirmary of Edinburgh.

“We are also reviewing unscheduled care. We work hard to ensure more vulnerable patients, including older people and those with dementia, are not moved unless absolutely necessary.”