When it was launched by the then minister of health, Aneurin Bevan, on July 5 1948, it was based on three core principles:
- that it meet the needs of everyone
- that it be free at the point of delivery
- that it be based on clinical need, not ability to pay
Our NHS staff are doing the best they can under the circumstances, but they are over worked, undervalued and under resourced.
The 2015 annual NHS staff survey revealed only a third of NHS staff believe there is enough of them to do their jobs properly.
BMA Scotland warned that our NHS will struggle to deliver all the services that patients need without urgent and significant change, while, according to a Royal College of Nursing survey, only 12.8% of Scotland’s nurses don’t believe the NHS can meet expectations.
When NHS staff are overworked and undervalued patients lose out.
It’s time to build a health service fit for the challenges of the future
This briefing is on delayed discharge.
Since regular reporting began four years ago, our NHS has lost more than 2 million days to delayed discharge.
We’ll make the case for progressive taxation to protect public services.
We want to use the new powers of our Scottish Parliament to ask the richest to pay a bit more so we can stop the cuts to public spending and invest in Scotland’s future.
The Briefing: Delayed discharge under the SNP
What are delayed discharges?
The Information Services Division (ISD) Scotland provides health information, health intelligence, statistical services and advice that support the NHS in Scotland.
They explain :
“A delayed discharge is a hospital patient that is clinically ready for discharge from inpatient hospital care but continues to occupy a hospital bed beyond the ready for discharge date.”
How many ‘bed days’ are being lost to delayed discharge?
ISD Scotland began regular public publication of Bed Days Occupied in August 2012 which included data from April 2012.
Bed days are the number of days patients spend delayed in hospital following their ready for discharge date.
In calculating the number of bed days which are occupied by delayed discharge patients all days that occur between the ‘ready for discharge’ date (RDD) and the discharge date (the date the delay ended) are counted.
The ‘ready for discharge’ date (RDD) is not counted however the ‘discharge date’ (the date the delay ended) is included. Since reporting began over 2.25 million bed days have been occupied by delayed discharge patients.
What are the reasons behind delayed discharge?
There are a number of reasons why a patient may have their discharge delayed. In general, delayed discharge happens when an elderly patient requires assistance at home but there is a problem with accessing local authority support.
Cuts to local government funding only add to that problem.
In 2015/16 a third of standard delays were patients waiting to go home
( ISD Scotland state “Patients waiting to go home: patients waiting for care arrangements to be put in place in order to go home), while 1 in 4 delays was patients awaiting a Community care assessment.
Why recording delayed discharges matters?
The experts at ISD Scotland state that :
“Timely discharge from hospital is an important indicator of quality and is a marker for person centred, effective, integrated and harm free care.”
Quite simply it is important to get people out of hospital as soon as they are fit to leave for their own safety. Furthermore, patient flow through a hospital is significantly impacted when beds are unnecessarily occupied by patients who are ready to leave.
What is Labour’s plan to tackle the problem?
Labour plan is to use the powers of the Scottish Parliament to stop the cuts to our public services. Dealing with delayed discharge and taking the pressure of our hospitals means properly funding social care in Scotland.
Scottish local authorities who deliver social care have faced a £1.4 billion cut since the SNP came to power in 2011.
Research carried out by MND campaigner Gordon Aikman revealed that 270 people died in 2015 waiting for a social care package.
Faced with the choice between using the powers or continuing with cuts, we believe that government should use the powers.
Fixing social care doesn’t just require investment, it needs reform too – with one in five care workers leaving their job each year something needs to change.
That is why Labour is calling for the establishment of a National Guarantee for care workers and implementing Unison’s Ethical Care Charter to provide staff with the professionalised industry that they and patients deserve.
That would mean:
· Every care worker paid the living wage
· Ensuring they are paid for travel cost and travel time
No zero hour contracts
· Appropriate training for staff
Only a package of funding and reform can solve the problem of delayed discharge in our NHS – and take the pressure of our hardworking staff to let them deliver for patients.