Delayed hospital discharges in South Ayrshire continue to increase, a new Ayrshire and Arran health board report shows.

Meanwhile, bed blocking figures for both East and North Ayrshire health and social care partnerships remain far lower and relatively stable.

However, the figures reveal that East Ayrshire recorded the highest percentage increase in hospital ‘bed days’ lost between September and November last year.

All three partnerships are working with NHS Ayrshire and Arran to develop a system to reduce and prevent admissions and speed up discharges from hospital.

The primary reason for delayed discharges is because care services are unavailable to those who require to leave hospital.

South Ayrshire is particularly affected because it has traditionally commissioned private care for 80 per cent of its care needs.

This sector has been hit by staffing and recruitment issues, resulting in a major shortfall of care. North and East Ayrshire both utilise more in-house care, avoiding the same level of disruption.

A report to next week’s Ayrshire and Arran health board meeting states that the total number of bed days lost because of delayed discharges within the boundaries of NHS Ayrshire and Arran was 7,244 in November 2022.

This is around 23 per cent higher than the previous figure of 5,975 days in September 2022.

The statistics become even more stark when they are broken down by authority.

In November, Ayrshire and Arran recorded a total of 246 delayed discharges, compared to 191 in September, an increase of 28 per cent.

The vast majority of these relate to South Ayrshire, where the figure rose by 30 per cent from 111 cases last September to 145 in November.

North Ayrshire saw a 33 per cent increase, from 53 in September to 71 in November.

In terms of the number of discharges, East Ayrshire remains by far the best performing authority, with an increase of 11 per cent, from 27 in September to 30 in November.

When it comes to delayed discharges of a fortnight or more, the challenge facing South Ayrshire health and social care partnership becomes even clearer.

In September, South Ayrshire accounted for 77 of the 96 patients who could not be discharged for more than two weeks.

North Ayrshire made up the other 25 per cent, with 19 cases, while East Ayrshire had no delayed discharges taking more than a fortnight.

By November, 96 (85 per cent) of 113 cases were in South Ayrshire.

The number of cases actually dropped to 17 (15 per cent) in North Ayrshire, while East Ayrshire maintained its long-standing run of no discharges of more than two weeks.

The report outlines plans to address the problem of bed blocking in all three health and social care partnerships.

It states how private care providers can return care if they cannot meet a patient’s needs. With staff shortages, sickness and recruitment issues, this has had an impact, the report says.

South Ayrshire has had to bring around 300 hours of care a week in cases that would have been commissioned with the private sector.

It has also had the knock-on effect of increasing the waiting list for home care to 169 people, with a further 240 awaiting a home care assessment.

The SAHSCP had been using beds in council-run care homes to support patients waiting on care packages, but they have admitted all 26 beds have been ‘exhausted’.

The HSCP says it is not moving for any extra interim beds but, when an interim bed becomes available, it will be offered to someone delayed in hospital.

South Ayrshire HSCP is also taking a ‘home first’ approach which has seen its enhanced intermediate care team working with staff at Ayr Hospital to ‘promote’ the approach.

It is also working with the other HSCPs in Ayrshire to develop a sustainable model which will prevent admissions and speed up hospital discharges. While it is at an ‘early stage’ the report indicates that expectations are positive.

North Ayrshire HSCP’s efforts were also noted in the report.

The North partnership recently reviewed its systems for utilising interim beds for those people who can be discharged for assessment to consider their longer-term care needs out with a hospital setting.

The report continued: “The partnership has a targeted plan for winter investment. Recruitment for this investment is advanced with a number of posts having commenced and this activity will remain ongoing until complete.

“These plans included significant investment in the care at home workforce and a comprehensive ongoing programme of recruitment to the care at home service has been ongoing for several months.

“It has, however, proven to be challenging recruiting to all vacancies and this has been further compounded by challenges in retaining social care staff, however the partnership is confident that the impact of this investment will be seen in the coming months.”

East Ayrshire HSCP is also looking to make improvements.

The report states: “All community teams are working together to continue to prioritise supporting people and their families at home, with a key focus on enablement, well-being and carers support to increase prevention of admission.”

East Ayrshire HSCP is working to increase ratio and volume of in-house to commissioned care at home services to support more people at home and ensure discharge without delay.

The report continues: “The HSCP is investing in developing the model of care at East Ayrshire Community Hospital to provide advanced nurse practitioner and allied health professional capacity together with supporting rehabilitation and enablement resource to support discharge at earlier point without delay.”