Shortage of carers fuelling hospital crisis

Eileen Reid had to be assessed before being allowed home to make sure all the care she needed was in place

A lack of care staff is fuelling the crisis in Scotland's hospitals.

The pandemic exposed cracks in the health and social care system, laying bare how fragile the care sector was.

Now, as the country is heading towards what the first minister calls a "difficult winter," a shortage of care staff threatens to stand in the way of a health system trying to get back on its feet.

On Thursday, Nicola Sturgeon was challenged to publish Scotland-wide figures on the extent of staffing shortages - and she acknowledged the profound impact when services were disrupted.

In Aberdeenshire, officials estimate there is a gap of around 350 staff across the local authority workforce.

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Eileen Reid, 87 is back home in Inverurie after a fall. Things have had to be moved around to keep her safe.

"My daughter's getting a bed brought down so I don't have to go upstairs," she says. "Going up and down the stairs, that's where I fell, on the last few stairs."

'Freeing beds is essential'

Before being discharged, she was put through her paces in the geriatric assessment unit at Aberdeen Royal Infirmary.

There, dozens of people are assessed every day, and either moved on to other departments for treatment, or ideally discharged home.

Covid protocols have made the process more complex, but freeing up beds here as quickly and safely as possible is essential to the flow of patients all the way through the hospital.

Getting patients from hospital to their homes requires complicated care packages which rely on care staff and when those are not there, it can mean longer stays in hospital

Eileen was supported by a team, including occupational therapist Lindsey Fisher. She aims to get frail elderly patients home from hospital as soon as it's safe to do so.

"Even with just a few days in hospital somebody can really deteriorate in their abilities, because it takes their independence away," she says. "For the frail elderly, for their mental health, and the confusion of being in a different setting and away from their own home, it's just better to be in their own environment."

Lindsey is helping to cover staff shortages by working shifts in hospital as well as in the community. She says finding care is one of the biggest challenges, and making sure all the important information is handed over to local services and family members.

'A lack of carers'

Hannah Johnston is a physiotherapist who works alongside her.

"The care, the equipment, all those need to be in place before a patient can be discharged," she says. "They need to be safe as well as medically fit. So it's not just one single thing that can allow a patient to go home, there are multiple factors, and sometimes patients can be waiting for care so they're in hospital for a longer time."

Sandra Stewart manages care from the hospital's discharge hub, matching up patients with the help they need in the community.

She says: "The single biggest issue for us in the lack of carers that are available to support patients in their home. We can get patients home from hospital but the care has to be continuous, has to be available when the patient returns home."

Physiotherapist Hannah Johnston says there are a lot of things that need to be in place before a patient can return home

Agencies such as ARCH (Aberdeenshire Responders for Care at Home) travel the local authority area, bridging the gap between hospital and care at home.

Sophia Buchan says her workload has increased because of staff shortages.

"There are not enough carers, there are a lot of home carers leaving the profession because they feel undervalued, underpaid, and that adds the pressure to us, because then we have to pickup the fallout, and so we end up having an extra job to do, running here, there and everywhere," she says.

"What they really need to do is get more carers on the go and encourage them to join the profession. Instead of them wanting to leave, make sure that they want to stay.

"It's a fantastic job. I love it. I do love my job."

While the north-east is feeling the effects of a lack of care staff, the rest of the country has not escaped the issue.

'Profound concern'

Nicola Sturgeon said on Thursday that she wants to see social care services in Glasgow resume as quickly as possible, after staff shortages forced day-care provision to be temporarily suspended.

She said the Scottish government was working to increase the size of the workforce across the social care sector.

Labour MSP Pam Duncan-Glancy raised the issue at First Minister's Questions, urging the first minister to deal with the crisis in social care recruitment and tackle "grossly unfair" pay in the sector.

Ms Sturgeon said the government was working with all local councils to encourage take-up of vacant social care posts.

She said: "This will be of profound concern to anybody who is affected by this temporary suspension of services and everybody wants to see them reinstated as quickly as possible."

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