East Ayrshire Council 'penalised' for success in limiting delayed hospital discharges

The Care Inspectorate noted the “friendliness, kindness and helpfulness” of staff and how they established "good and supportive relationships" with the people they supported
-Credit: (Image: Getty Images / Jacobs Stock Photography Ltd)

Councillors want more acknowledgement and support for East Ayrshire’s success in minimising delayed hospital discharges.

There was also a warning that the financial pressures on care could see the criteria for services tightened at East Ayrshire Cabinet this week.

East Ayrshire Council and Health and Social Care partnership have been able to almost eradicate delayed discharges in recent years.

This has, in turn, helped free up beds for NHS Ayrshire and Arran.

However, EAC cabinet members pointed out that despite the NHS reaping the rewards, there is no financial compensation for the significant resources used by the council to maintain this standard. They also pointed out that other councils were not achieving the same success, even within Ayrshire.

Councillor Ian Linton said: “I really think that good behaviour should be rewarded.

“We do exceptionally well in terms of delayed discharges, but we don’t seem to be getting any financial compensation from (NHS) Ayrshire and Arran for keeping people out of hospital. This is something that I think we should pursue. I don’t think Ayrshire and Arran are in a position financially.

“We should be contacting the Scottish Government to flag this up as we are doing the right thing and we seem to be being penalised for it.”

Council leader Douglas Reid replied that there were already representations being made.

Chief Executive Eddie Fraser added that there is a review of the integration of the health and social care partnership, which will include the financial arrangements.”

Councillor Maureen McKay said: “We do a great job in terms of not having delayed discharges and ensuring all identified needs are assessed. That is not the case across all of Ayrshire. We perform quite differently as an IJB compared to others across Scotland.

“We have done something slightly different to rebalance our position in terms of what percentage are in-house community care and what percentage is external. I have got some concerns that we might find ourself pushed to look again at what the qualifying position actually is and what is the criteria?”

Mr Fraser, the former boss of East Ayrshire Health and Social Care Partnership, acknowledged the issue.

He said there would be a number of areas being looked at to reduce the funding shortfall, one of which is eligibility criteria.

He explained that East Ayrshire was unusual in having more open eligibility, accepting moderate, substantial and critical risk users. Most only provide care for substantial and critical risk residents.

Mr Fraser added that they could not have a situation arise where someone with a critical risk was unable to receive care because of resources used on moderate cases. The review will also look at the in-house versus private provision of care.

The fact that East Ayrshire has a higher percentage of care provided in house (70 per cent) has been a factor in minimising delayed discharges.

This compares to South Ayrshire, where care at home is mostly private and third sector and the level of delayed discharges is significantly higher.

However, Mr Fraser acknowledged that the financial constraints mean that this will also be looked at.

He said: “It is not only about cost, but also flexibility.”

There would also be an option to provide more funding if there is no will to change the allocation.

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