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Thursday, 12 March 2015

System pressures compromising care for older Scots, RCN

Written by The Editorial Team

Pressures on our health and social care system are compromising fundamental standards of care for older people in hospital, according to a new Frontline First briefing published today by the Royal College of Nursing (RCN) Scotland.

Commenting on the briefing, Theresa Fyffe, RCN Scotland Director said: “When older people come into hospital, they are often acutely unwell. If our hospitals don’t have enough staff or enough beds and resources to manage the flow of patients coming through their doors, it is hard for them to provide the best possible care for their patients.”

This latest briefing is based on RCN Scotland’s analysis of 35 inspection reports by Healthcare Improvement Scotland (HIS) on older people’s care in hospitals.

HIS inspectors found that the majority of patients who were questioned said that the quality of care they received was good. However, RCN analysis of the inspection reports shows that:

  • Almost all of the inspections found hospitals did not appropriately screen and assess older people for cognitive impairment
  • Three quarters of the hospitals inspected needed to improve how they screened and assessed older people for under-nutrition
  • Over half of the inspections identified improvements needed in the assessment of pressure ulcers in older people.

Theresa continued: “Based on what we found from our analysis, many of our hospitals just don’t have the right systems in place. They’re struggling to manage, with inspectors reporting that two thirds of the hospitals inspected needed to improve the flow of patients through the hospital, with older people being moved from bed to bed, not being cared for or treated on the right ward for their condition or not being able to be discharged and so taking up desperately-needed beds.

"Our analysis also showed that NHS boards do not seem to be learning lessons from each other or even between hospitals within the same board. So a poor inspection report in one hospital may be followed a few months later by a poor inspection report in another hospital in the same Board area, with the same issues revealed.  This is clearly not good for our older people.

Theresa concluded: “Scotland has a growing population of older people, who are living longer, often with multiple and complex health conditions, and with the number of people aged over 75 predicted to rise substantially over the next 25 years, the pressures that this will put across the whole system are only set to increase.

“We know that providing quality care for older people takes time, resources and support.  Yet HIS’s improvement programme that helps NHS boards improve the quality of care for older people in hospital is only guaranteed funding until March next year. The Government must commit to long-term funding and invest in sustainable services so our older people can be assured that their care will be effective, safe and person-centred.”

To download this RCN Frontline First briefing, visit: