Trust ‘bullied’ social workers over patient discharges in Edinburgh

Trust ‘bullied’ social workers over patient discharges in Edinburgh
An NHS trust has been accused of bullying social work staff into
discharging patients from an Edinburgh hospital too quickly,
writes Derren Hayes.

A report by Edinburgh Council’s community services scrutiny panel
into the city’s Royal Infirmary (ERI) is highly critical of the
hospital’s management body NHS Lothian for pressuring social
workers into discharging patients to free up beds.

It comes just a week after an Audit Scotland report found
three-quarters of patients delayed in Scotland are waiting for
community care assessments or arrangements to be organised.

Marilyne MacLaren, chair of the scrutiny panel, said the evidence
had mainly come from GPs who had reported examples of patients
being discharged from ERI before an appropriate care package was in
place or their condition had stabilised.

“If you have a lot of pressure to free up beds then you can
understand Mrs Bloggs being discharged when in an ideal world she
would stay in longer,” MacLaren added.

She said social work staff interviewed backed up the claims by GPs
in private but were too afraid to go on record with them because of
the “culture of fear” they were working in. She added that social
workers need to be “more robust” in dealings with the NHS.

“Social workers said there was a bullying culture within NHS
Lothian but to get someone to say that in public was very
difficult,” MacLaren said.

The report puts much of the blame for the increased pressure on
beds down to the delay in developing intermediate care services – a
recently opened facility in Leith was two years late – which
MacLaren said had been promised but not delivered by NHS Lothian.

David Bolton, chief operating officer for University Hospitals
Division, said he was surprised by the report’s findings because
readmission rates, a key indicator of premature discharge, were
falling.

Meanwhile, new figures from the Scottish executive show the number
of patients who had their discharge from hospital delayed by more
than six weeks dropped by from 1004 to 717, or 28.6 per cent,
between January and April. This was an 18.1 per cent reduction over
the past 12 months. Figures at www.scotland.gov.uk

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