Age Scotland has said the amount of patients who die while waiting for discharge shows the need for urgent action in social care
Hundreds of Scots died in Scottish hospitals while waiting to be discharged last year, new figures have revealed.
Age Scotland labelled the near 500 deaths tragic and said urgent action is needed to tackle the growing problem of delayed discharges and an over-stretched social care system.
A Freedom of Information request by the charity revealed 474 patients, mainly older people, died in hospital after their discharge was delayed. The vast majority (423) were waiting for health and social care packages to be put in place.
This is a steep rise on the previous year’s total of 400, with 353 delayed for health and social care reasons. The figures have consistently increased in recent years, with 373 deaths in 2016 and 282 in 2015.
There was wide variation throughout Scotland, with NHS Lothian reporting 86 delayed discharge deaths, the highest number in Scotland, between April 2018 and March 2019.
This was followed by Grampian (at least 83 deaths), Greater Glasgow and Clyde (69), and Ayrshire and Arran (59).
Only 13 died in the Borders, while Tayside reported fewer than 15 deaths.
Brian Sloan, chief executive of Age Scotland, said: “It’s tragic that hundreds of Scottish people died while stuck in hospital last year, instead of in their home or community. These are people who were well enough to be discharged, but most were delayed because the social care they needed was not available.
“While these deaths were not caused by delays, we know that spending unnecessary time in hospital increases the risk of mobility loss and infection, as well as loneliness and isolation.
“Many of these people had been in hospital for weeks, spending the end of their lives feeling isolated on hospital wards instead of in the comfort of familiar surroundings. The overwhelming majority of people say they would prefer to die at home if possible, or at least in the comfortable setting of a care home.
“Despite the Scottish Government’s repeated promises to tackle delayed discharges, these figures show that the problem is spiralling out of control. We urgently need more investment in our social care system, so that every older person can access the care they are entitled to.”
Age Scotland’s Waiting for Care report found this year that 43% of older people with critical or substantial needs wait longer than the six weeks outlined in national guidelines for the social care they need.
Marie Curie's Richard Meade said the figures rightly draw attention to a critical issue facing people at the end of their life.
"Three in ten people in hospital are in their last year of life and when people have a terminal illness, time is short and many don’t have the time to wait," he said.
"For some people hospital is the appropriate place for them to be cared for, but for many, being in hospital is not where they want to be, and although coming to the end of their life they can be supported to be at home and die there if that’s what they want and choose. These latest figures show that many are missing out on person-centred care and support for them and their carer or family members. This support is vital to ensuring people live as well as they can in the time they have left.
"Currently, one in four people are still missing out on the care they need as they approach the end of life, which can lead to unplanned admissions and extended stays in hospital. With our ageing population more people will be living with complex health conditions as they enter older age and approach the end of life. If we do not fully resource and support our community and primary care services now then this problem will only get worse, as these figures show.
"Working in partnership with the NHS and social care services, Marie Curie has been able to successfully prevent avoidable admissions and reduce the number of delayed discharges in some cases. However, this is not the case for everyone across Scotland and we’d urge the Scottish Government and Health and Social Care Partnerships to look at how we support people living with terminal illnesses and approaching the end of life through integrated services delivered in partnership with the third and independent sectors.”
A Scottish Government spokesman said: “We want people nearing the end of life to get the care and support that is right for them, in a place that is right for them. No one should have to spend unnecessary time in hospital once treatment is complete. This emphasises the importance of the continued development of a range of community based services by local health and social care partnerships to let people be cared for longer in their own homes.
“We are allocating more than £700 million to support social care and integration in 2019/20, an increase of 29%, and continue to work closely with health and social care partnerships to ensure the good practice which exists in many areas is spread across Scotland.
“In addition, we are working with Cosla, unpaid carers, people who use services and the social services sector to take forward a national programme to support local reform of adult social care support.”
