SEVERE pressures affecting health and social care services across Dumfries and Galloway were a key focus of discussion at Monday’s meeting of the NHS Board.
Particular concern was expressed about the chronic shortage of funded social care support for people outside hospital.
Chief Executive Julie White revealed that, at points in recent weeks, around a quarter of beds within Dumfries and Galloway Royal Infirmary have been occupied by patients who were medically fit for discharge but remained in hospital awaiting support elsewhere.
The Board heard how limited social care capacity is reducing available hospital capacity and creating pressure throughout the healthcare system, from ambulance handovers and Emergency Department waits through to admissions, treatment and discharge.
Chair of NHS Dumfries and Galloway Mark Cook said: “Our priority is ensuring people continue to receive safe and effective care, and today’s discussion reflected the seriousness of the pressures currently facing health and social care services.
“These challenges are being experienced across multiple parts of the system and cannot be addressed by any one organisation working alone.
“We have been having focused discussions with Dumfries and Galloway Council and the Integration Joint Board about the pressures we face, the risks these pressures create and the options available to help address them.”
The Board heard that pressures affecting hospitals, community services, primary care and social care are increasingly interconnected, with challenges in one area often having consequences elsewhere across the system.
Chief Executive Julie White said “Our staff continue to show extraordinary professionalism and commitment in the face of severe pressure.
“Across health and social care, people are working incredibly hard to support those who need our help. However, the sustained level of delayed discharge we are currently experiencing is creating significant challenges for patients, staff and the wider system.
“We have been clear with partners about the seriousness of these pressures and discussions are continuing regarding the options available to help address them.”
NHS Dumfries and Galloway is continuing to take forward measures within its own services aimed at maximising available capacity, improving patient flow and ensuring resources are focused where they can have the greatest impact on patient care.
This includes renewed work around assessment and decision-making at the front door of acute services, ensuring people receive care in the most appropriate setting, supporting effective flow through hospital and making sure finite clinical resources are directed towards those with the greatest medical need.
Board members were advised that 116 people across NHS Dumfries and Galloway’s hospital estate are currently medically fit for discharge but remain in hospital for reasons that can include need of care or awaiting guardianship or a care home. The Board heard that the limited availability of social care and care packages has become one of the most significant constraints on improving patient flow through the system.
The impact is felt throughout the system. Some people are spending hours in the Emergency Department, patients are being cared for in corridors or doubled up in rooms, scheduled operations are having to be postponed, and ambulances can be tied up on site for hours waiting for patients to be admitted.
Chief Operating Officer Nicole Hamlet said: “Nobody should underestimate the scale of the challenge facing health and social care.
“We’re conscious that many people are spending longer in hospital than they should, and this has potential implications for their welfare and those of others who need medical help.
“This is no fault of the individuals involved, and we’re grateful for all the help being provided by families and Carers. Most people would much rather be supported at home or in a more appropriate care setting than remain in hospital.
“However, it underlines why the discussions currently taking place between the NHS, the Integration Joint Board and Dumfries and Galloway Council are so important as we approach what is likely to be another extremely challenging winter.”
The Board expressed its gratitude to staff across health and social care, as well as unpaid Carers, voluntary organisations and independent providers, for the vital role they continue to play in supporting local communities.