By Alan Beresford

Copyright grampianonline

“Transformational” work is required to address care the widespread impact of care package delays, a local councillor has warned.

Moray Council’s joint Older Person’s Champion Councillor Sonya Warren (Buckie, SNP) has voiced deep concerns that, while progress has been made, the “ripple effect” from the backlog will hit a wide range of services, ranging from delayed hospital discharges to housing.

She pointed to recent figures from Moray Joint Integration Board (MJIB) which show that while the number of delayed discharges has reduced by 44 per cent compared to previous years, the overall number of hospital bed days lost to delays has increased, with 1501 days recorded in March 2024 compared with 751 in March 2023.

Councillor Warren said: “We all want people to be cared for in the right place at the right time.

“While progress has been made, the reality is that too many people in Moray are still waiting in hospital for care and support that isn’t yet in place.

“This not only affects patients’ recovery – and also means people who really need to be in hospital suffer delays due to the shortage of beds – but also puts pressure on their families, our NHS and our wider council services. Delayed discharges don’t just affect the NHS, they have a ripple effect across Moray Council services.”

She went to state that social care staff were under pressure to arrange emergency care packages often at “short notice” while there has been an increase in requests for home adaptations and suitable accommodation.

In cases where support is not in place, carers – including young carers – ‘face added strain”.

The delays also bring financial consequences, with Councillor Warren saying that the overspend on delayed discharges is estimated to be in the region of £2.5 million for Moray, which has a wider impact on the local authority’s wider budget. Overall, MJIB had an overspend to the tune of £7,420, 760 over 2024-25, which has impacted on this financial year’s budget by £5,987,722.

She continued: “Behind every number is a person, someone’s mother, father or grandparent, waiting to get home or into the right care setting.

“Staff across health and social care are working tirelessly, but the reality is we face ongoing challenges with workforce shortages, recruitment in rural areas, and the backlog of care assessments.”

MJIB has introduced new measures, including daily system-wide coordination meetings, the rollout of the Home First approach, and pilot programmes for Discharge to Assess services. While she believes these steps are beginning to show positive results, Councillor Warren says more is needed:

“We need to keep investing in care at home, supporting our care workforce, and making sure housing adaptations are delivered quickly.

“Progress has been made, but there is still much to do to ensure people in Moray can return home with dignity and without unnecessary delay.

“What’s needed is transformational work including with recruitment and investment in care and home. There’s so much good work being done by staff who continually go above and beyond, but things need to be speeded up.”

Judith Proctor, Chief Officer of Health and Social Care Moray., described care at home provision as “fundamental.

She continued: “We currently provide around 15,000 hours of care each week to 900 people through a mix of our own internal service and commissioned providers.

“People are also supported to use the full range of self-directed support options, giving them more choice and control over how their care is arranged. This can, for example, include them arranging their own care provision directly.

“In recent months, we have opened the external market to more providers, creating additional capacity, but demand for care at home continues to rise.

“Our dedicated staff and partners work extremely hard to begin support as soon as capacity becomes available, balancing the needs of those already receiving care at home from a regular team of skilled social care assistants, with bringing new people on to staffing rotas.

“Sometimes, people’s existing support arrangements must be increased to ensure care can continue to be delivered safely – for example, when a person’s mobility decreases and more than one carer is needed to assist. While essential for safety, this reduces care available for others.

“In situations where care must be arranged urgently – for example, if a family carer becomes unwell or informal arrangements break down – staff act quickly to put support in place, but this delays the start of support for new people.

“At present, 129 people have been assessed as requiring care at home and are waiting for it to be arranged. We hold weekly meetings to review everyone on the waiting list, ensuring those with the highest needs are prioritised. Anyone whose circumstances change while waiting is encouraged to contact our Social Work teams for reassessment.

“The majority of people delayed in their discharge from hospital in Moray are being cared for in our community hospitals, rather than in an acute setting such as Dr Gray’s. Older and frail patients are more likely to experience delays as their needs are often more complex, requiring more time to arrange support at home, a place in residential care, or housing adaptations. We work closely with our colleagues in the acute sector to ensure good joint working to discharge people in a timely manner.

“We greatly value the vital role played by families and unpaid carers in supporting people to continue living at home. Our Carers’ Strategy (https://www.hscmoray.co.uk/our-partnership/strategies/) sets out our commitment to recognise and support carers both through our own teams and through Quarriers, our commission service for unpaid carers of all ages.

Ms Proctor went on to say that while Councillor Warren is correct to say the MIJB was overspent on core services by £7.420 million last year, delayed discharges are not driving the overspend. She went on to state that it was the result of increasing demand (across children’s as well as adult care), increasing costs (such as pay awards) and undelivered efficiencies and savings.

She added: “Like all public sector services, Moray faces significant financial pressures.

“The Moray Integration Joint Board, funded by Moray Council and NHS Grampian, does not have an unlimited budget for care at home.

“The scale of demand means support cannot always be provided as quickly as we would wish. We continue to work closely with partners to make the best use of our available resources, prioritising those in greatest need and taking sustained action to expand capacity and reduce delays wherever possible.”

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