Covid Scotland: Lack of social care provision should worry us all as pandemic's impact continues – Elsa Maishman

There are plenty of reasons why the NHS in Scotland is under pressure: Not enough staff, Covid backlogs, patients becoming sicker as they languish on waiting lists, and many others.

But there is one aspect that almost everyone, working across every area of the system, will mention: social care.

Doctors say this is why waiting-times performance at Accident and Emergency departments has been so dire recently, why so many hospital admissions have been delayed, and even one of the reasons why you may be struggling to get an appointment with your GP.

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Social care in Scotland is facing huge demand alongside crippling staffing shortages, which has caused widespread delays. It means patients who are otherwise fit to be discharged from hospital must instead remain there, as a care package cannot be put in place for them at home, or they cannot be moved to a care home.

The provision of social care affects a large proportion of the population in one way or another (Picture: Getty Images)The provision of social care affects a large proportion of the population in one way or another (Picture: Getty Images)
The provision of social care affects a large proportion of the population in one way or another (Picture: Getty Images)

Beds not being vacated in turn means delays in patients being admitted to hospital from A&E, causing waiting times to lengthen, and creating more work for already overstretched staff.

These delayed hospital discharges have been at record levels in recent weeks. The highest figure since the start of the pandemic, 1,683, was reported at the end of March, while the following week – the most recent for which we have data – saw 1,679. This time last year the figure was around 1,000.

Soaring hospital waiting lists have also led to GPs caring for patients with worsening conditions as their wait drags on. And when they find themselves with patients who cannot look after themselves alone but would do perfectly well with a social care package, they are often forced to refer them to hospital instead.

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Social care affects a huge swathe of society. A new report from Public Health Scotland published this week shows one in 25 people received social care services at some point in 2020/21. In that time, 44,000 people were given funding for a long-stay place in a care home, while in the first quarter of 2021 some 68,000 people were receiving care at home.

The report reveals the impact of the pandemic, including an almost 40 per cent year-on-year drop in the number of people supported during a short stay in a care home.

Overall the number of people receiving care has fallen by about 10,000 since before the start of the pandemic. This is unlikely to be because fewer people need care – this figure should be rising with an ageing population.

It is more likely people in need are not receiving it, and are either being delayed in hospital, forced to seek care elsewhere, or rely on family members or other unpaid carers.

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The number of unpaid carers has also risen hugely. There were believed to be around 700,000 to 800,000 in Scotland beforehand, but this is thought to have grown to over a million, and is probably far higher in reality.

The Scottish Government is still considering its plan for a National Care Service, with the intention for it to be up and running by 2026. With such a widespread impact on the NHS, and the effects of the pandemic expected to be felt for many years to come, this won’t be soon enough for a solution.



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