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Government commits to ward moves action

12 June 2012

Scotland's Health Secretary Nicola Sturgeon is considering the introduction of targets to reduce the number of times a patient is moved whilst in hospital. 

This was revealed following the release of a Royal College of Physicians of Edinburgh survey suggesting patients are routinely taken from specialist wards and placed in general wards, especially during winter.

The Cabinet Secretary said that the practice, known as boarding, would be among the topics of discussion at a meeting on targets with the Royal College (RCPE), whose online survey, completed by 290 doctors and consultants, was the result of approaches from a number of hospital consultants concerned at the level of both admissions and boarding in their areas. 

Dr Neil Dewhurst, RCPE president, said: "While we believe there has been a steady increase in the number of patients with medical conditions admitted to hospital across Scotland, the number of hospital beds for acutely ill patients remains under significant pressure and the number of consultants has not been increased to respond to this demand.

"In most hospitals, consultants have no alternative but to move patients on to other wards where they will receive less specialised care and which often results in delays to their care. There is strong evidence that this reduces quality of care for patients and increases their length of stay.

"Boarding, in effect, creates a vicious circle, delaying treatment and discharge for patients and adding considerably to the workload of the healthcare teams caring for them and we believe this is poor practice, places patients at risk and is unacceptable" he added.

Ms Sturgeon said she took the college's concerns "very seriously" and that "there is no doubt" that the Government wants to eliminate boarding from the health service.

She told BBC Radio Scotland: "One of the things we have been discussing, before this report, was the issue of setting a particular target for health boards in future years to reduce boarding and that is also something that we will be happy to discuss with the Royal College. It is obviously an issue that involves the entire hospital system and it is important that it is tackled on that whole system basis." 

Age Scotland spokesman Lindsay Scott said: "We welcome this commitment to address this issue, one which by the Scottish government's own admission in a report published last year, leads to a greater likelihood of death within 30 days of discharge.

"And while we fully back shifting care from hospitals into the community, this cannot happen until services to treat very unwell people at home are in place. We are concerned that if ‘boarding' is allowed to continue, more older patients will be shunted from ward to ward, increasing the probability of their being re-admitted as an emergency within 30 days and resulting in longer inpatient stays and perhaps more serious outcomes.

"Furthermore, boarding can be extremely confusing to frail, older patients and with an ageing population and the increasing demands on in-patient beds due to unexpected outbreaks of infection, there is no doubt that the hospital capacity issues highlighted in the survey need urgent attention."