Concern over elderly ‘boarded’ in hospital over social worker delays

Dozens of elderly patients were kept in a major hospital despite being well enough to be discharged, according to an inspection report which raised grave concerns about the care given to older people.

According to a new report from Healthcare Improvement Scotland (HIS), 48 patients who were listed as “delayed discharged” at the Southern General Hospital, Glasgow and had waited up to 54 days to be allocated a social worker to allow needs assessment.

HIS said it had concerns about the flow of patients and capacity at the hospital and inspectors identified 16 areas where improvement was needed.

But it is the specific issue of the use of ‘boarding’ that has raised the most concern. Boarding is the movement of patients between wards due to pressures on beds.

This practice, which often means patients are cared for on wards outside of the specialism they should be treated in, has been severely criticised as leading to worse outcomes for patients and many medical experts have called for it to be banned.

Officials from Healthcare Improvement Scotland said they were “very concerned” about the practice, which they said was both “detrimental” to patients and had a direct impact on the number of people who can be admitted to wards.

Jacqui Macrae, head of quality of care for HIS, said: “During this inspection, we were particularly concerned about patient flow and capacity within the hospital. On the majority of wards inspected we found no evidence of care plans being used to inform and evaluate the care given to patients.”

The inspection report noted two areas of strength at the hospital and listed 16 areas for improvement. The staff were described as friendly and polite, and the report praises the garden area designed for patients using the medicine for the elderly unit.

But in addition to the issue of overcrowding and delayed discharges, issues were also found with the assessments patients require when they are admitted to hospital.

Rory Farrelly, NHS Greater Glasgow and Clyde’s Acute Director of Nursing, said: “We are sorry that in a number of areas we are still falling short of the standards expected in all our hospitals.

“Clearly we need to reinforce some of our policies with staff and provide additional training where required.”

Jim Pearson, deputy director of policy at Alzheimer Scotland, said: “A number of problems highlighted in this report are unacceptable, particularly those relating to the inappropriate moving of patients between wards. Sadly, they are not uncommon.”

The opening of the new Southern General hospital next year will increase numbers of hospital beds in the city. The Southern, Western and Victoria hospitals, including Mansionhouse, currently have 1620 beds. The new Southern General will have 1631 beds.