NHS Lothian and the city council are on a collision course with the Scottish Government after a leaked internal e-mail revealed patients on delayed discharge will be sent home from hospital without an appropriate care package in place.
The health board, who were at the centre of a new A&E waiting times scandal earlier this month which saw reporting guidelines breached at hospitals across the region now plan to send patients home to “await assessment for any additional support”.
The e-mail obtained by the Evening News and widely distributed to NHS staff talks about “the significant pressure on the availability of new packages of care”.
In their most recent papers the Edinburgh Integrated Joint Board who are responsible for providing health and social care across the city admitted that the Capital regularly has the highest number of delayed discharges in Scotland.
Local contracted providers have reported high turnover rates of care staff in the region of 30 to 50 per cent in some instances. This comes on the back of a proposed £3m worth of savings to be made to the city’s care budget for 2018/19 amid continued pressure to meet NHS targets.
Jacquie Campbell, Chief Officer of Acute Services, NHS Lothian, said: “Our priority is the safety and wellbeing of our patients. Every patient is clinically assessed before they are allowed home. If patients are clinically fit for discharge and are awaiting straightforward social support, they can wait at home in familiar surroundings, rather than in a busy, acute hospital, such as the Royal Infirmary of Edinburgh. We work very closely and professionally with colleagues in the Edinburgh Health and Social Care partnership to ensure we deliver the best possible care in the right place.”
The Capital is in the midst of a care crisis with, according to the latest figures available, over 800 people still waiting to be assessed for provision, including 700 who have not yet received care packages and 159 people delayed in hospital.
Michelle Miller, Interim Chair of Edinburgh Health and Social Care Partnership said: “The arrangements referred to in the staff communication apply only to people who no longer require hospital care and are considered by clinicians to be able to go home to await assessment for any additional support that may be appropriate – it is certainly not a suggestion that those who are assessed as needing additional care such as residential or nursing care leave hospital unsupported.”
However, shadow health secretary, Miles Briggs, described the latest development as “alarming”.
He added: “Families of elderly and vulnerable people in Edinburgh will be understandably alarmed that the city’s health and social care partnership appears to be pushing for people to be discharged from hospital before any social care packages are put in place.”
A Scottish Government spokesperson said: “No one should wait longer than absolutely necessary to leave hospital and evidence shows an individual’s own home is the best place to assess longer term needs.
“Our policy is clear. When a patient is assessed as requiring care and support on discharge from hospital we expect local health and social care partnerships to ensure appropriate support is provided.
“That is why we have invested almost half a billion pounds of additional funds into social care and integr ation this year.”