Leadership needed to shift the balance of care

Monday 14th March 2016


Every day we hear about the huge strain on our National Health Service.  Just last week for instance the Greenock Telegraph reported that over 2,000 people presented at Inverclyde Royal’s Accident and Emergency Department had to wait more than four hours before being seen by a doctor.

Of course, this is not an issue solely effecting Inverclyde. It’s happening across Scotland. The pressures on A&E departments are symptomatic of a wider problem – the lack of care facilities in the community.

Patients ready to leave hospital are unable to do so either because they are awaiting a place in a care home or for appropriate arrangements to be made in their own home. This in turn, means that there are fewer beds for people turning up at the hospital doors.

This is not a new problem. It has been about for some considerable time. And with a rising elderly population and people with complex needs living longer the pressure on our hospitals will only increase.

In September 2011 the Scottish Government set out an ambitious vision for health and social care to respond to these challenges. However, having a vision is one thing, ensuring that vision is followed through is another.

Last week Audit Scotland – the country’s leading watchdog – strongly criticised the Scottish Government for failing to show leadership to shift the balance of care into the community.

The Auditor General Caroline Gardner said: “an ambitious vision can be a catalyst for change but, without a clear and detailed plan of action, there’s a risk that ambition is overtaken by circumstances.”

If we fail to shift care from our hospitals into the community the Scottish Government’s ambition to have more people cared for at home or in a homely setting simply won’t happen.

Now is the time for the Scottish Government to show leadership. As Audit Scotland said in its report it must provide a clear framework by the end of 2016 of how it expects NHS boards, councils and integration authorities to achieve the 2020 Vision, outlining priorities and plans to reach its longer-term strategy.