Hold-ups in social care system take blame for bed-blocking in Scotland

Hold-ups in social care system take blame for bed-blocking in
Scotland Most delayed discharges in Scotland originate in the
social care system not the NHS, an Audit Scotland report has
revealed.

Three-quarters of patients delayed in Scotland are waiting for
community care assessments or arrangements to be organised. Just
over one-fifth of these are waiting for a non-funded care
place.

The report shows that shortened assessment times by social workers
are the biggest factor in cutting delays, undermining a long-held
belief that poor procedures in the NHS are largely to blame.

Health care arrangements or assessments account for 9 per cent of
delays. Eight per cent are due to patients exercising their
statutory right of choice, often because their preferred care home
is full.

But the report shows that the length of the average delay has been
reduced by one-third to 102 days since 2001. At any one time, 8 per
cent of Scotland’s hospital beds are filled by a patient awaiting
transfer.

Though the findings suggest the executive’s policy of ring-fencing
£30m last year for local care and health partnerships to cut
delays is working, Audit Scotland is sceptical.

It warns that the executive’s target of a 20 per cent reduction in
the number of delays ignores the length of time people stay and
local circumstances. It could also discourage partnerships from
attempting further reductions.

The report points out that, under the grants system, there are no
financial incentives for partnerships to hit the target, and the
lack of information on the cost-effectiveness of local schemes
hinders monitoring.

The report adds: “The use of ring-fenced money has coincided with a
reduction in delayed discharges across Scotland although, because
partnerships may use additional funds, it is difficult to isolate
the effect of the specific ring-fenced element. This means that
neither the [social work] department nor partnerships can fully
assess which initiatives are successful.”