HIGH delayed discharge numbers are continuing to put further pressure on Fife’s hospitals, new figures have confirmed.

Performance statistics presented to the region’s Health and Social Care Integrated Joint Board (IJB) on Friday revealed that the total number of delayed discharge bed days had risen by more than 41 per cent year-on-year in December – from 32,196 in 2020 to 45,533 in 2021.

The 13,337 increase has been blamed on a significant increase in demand for complex care packages, and insufficient staffing levels to cover discharge from acute settings to community hospitals and social care provision safely.

Delayed discharge, or bed-blocking, happens when a patient cannot leave hospital because the other necessary care, support or accommodation for them is not readily accessible and/or funding is not available. 

COVID-19 has had a huge impact on patient flow across Fife’s hospitals, and efforts are ongoing to bring down the delayed discharge numbers to more manageable levels as soon as possible.  

Commenting on the most up-to-date figures available for December, Fiona McKay, head of strategic planning, performance and commissioning in Fife, said: “The Health and Social Care Partnership have some significant challenges in respect of hospital delays due to the high level of admissions to hospital.

“Work is under way with the investment planning to utilise interim care home beds to allow people to leave hospital and be admitted to a care home to await a care-at-home provision. 

“This information will be available and added to the performance data as we move forward to ensure we can demonstrate the significant work with the care-at-home collaborative set-up in Fife to ensure people's outcomes are achieved and they can return home as soon as a care-at-home provision is available.”

The pressure on health and social care services is perhaps borne out by the fact that there was a near-52 per cent rise year-on-year on the number of delayed discharge bed days caused due to health and social care reasons – from 20,114 to 30,536.

So-called ‘Code 9’ delays – complex cases where a delay in discharge is typically out of NHS Fife or Fife Council’s control – rose by 27 per cent over the same period, from 11,649 to 14,785. 

Those figures would include patients delayed due to awaiting place availability in a high-level needs specialist facility where no facilities exist and where an interim option is not appropriate; patients for whom an interim move is deemed unreasonable or where an adult may lack capacity under adults with incapacity legislation.

There was a welcome drop in the number of delayed discharge bed days brought about as a result of patient, carer or family-related reasons, falling from 433 to 212.

A number of measures are being taken forward by Fife’s health and social care partners, and it is hoped that the development of a Care at Home Collaborative, supported by Scottish Care, will allow care-at-home providers to work together to maximise resources and increase capacity to help patients return to their own home following an interim period in a care home.

Extra surge capacity has also been established to meet demand in wards at Kirkcaldy’s Victoria Hospital, Cameron Hospital in Windygates, Glenrothes Hospital and Dunfermline’s Queen Margaret Hospital. 

A spokesperson for the Scottish Government admitted social care services were under more pressure than at any previous stage during the pandemic.

“Recent months have seen extreme pressures across the whole health and social care system and this has seen more people coming through hospitals who need high levels of care and support to go home,” the spokesperson added.

“We have announced significant additional funding to address this, including £62 million to enhance care at home, £48m to increase the hourly rate of pay, £40m to support interim care arrangements and £20m to enhance multi-disciplinary teams.

“We have also recently launched our ‘discharge without delay’ programme, backed by £5m, to help local health and social care partnerships improve discharge planning arrangements.

“We are working alongside our health boards, and local partners with urgency and pace, to safely discharge people to their own homes or to an appropriate care home or community setting.

“We are doing this in the best interests of the individual involved and to also help us maximise capacity during this time of extreme pressure within our NHS.”