Five intensive care units fail to fully meet NHS requirements, audit finds

Staffing “challenges” contributed to almost a quarter of Scotland’s hospital intensive care units failing to fully meet key NHS requirements.

The latest Audit of Critical Care in Scotland also found delayed discharges from both ICUs and high-dependency units (HDUs) could be costing the NHS almost £19 million.

The audit for 2023 revealed five of the country’s 22 ICUs failed to comply with at least one of the Scottish Intensive Care Society’s Minimum Standards and Quality Indicators (MSQIs).

The report said “staffing challenges” across the multi-disciplinary teams had been a factor “contributing to the reason for non-compliance”.

Fourteen out of 25 HDUs also failed to comply with at least one of the MSQIs last year – with seven of the 25 units not achieving more than one of them.

“Staffing challenges were again amongst the main reason for this,” the audit, published by Public Health Scotland, said.

While there were 17,199 admissions to ICUs across Scotland, along with 20,586 admissions to HDUs, the report said delayed discharges were “challenging”.

Almost two-thirds (62%) of patients being discharged from ICU were delayed in 2023, the same “elevated level” as the previous year, “reflecting bed pressures across hospitals”.

Meanwhile, the proportion of HDU patients whose discharge was delayed was up from 59% in 2022 to 63% last year.

With the cost to the NHS of providing an intensive care bed amounting to an average of £2,957 a day in 2023, compared to the minimum daily costs for a ward bed of £606, the report said: “Delaying discharge may not only have a negative impact on patient safety, but also considerable cost implications for NHS Scotland.

“Excess costs resulting from delayed discharges in ICUs and combined units in Scotland in 2023 are estimated to be almost £15 million, however could be as much as nearly £19 million.

“Timely discharge from critical care is therefore essential for patient safety and reducing avoidable costs.”

Scottish Labour health spokeswoman Dame Jackie Baillie said: “This shocking report lays bare the true cost of SNP mismanagement.

“The SNP’s dangerous incompetence and lack of workforce planning has left vital critical care services struggling to cope.

“Delayed discharge is rising, doing damage to patients, piling pressure on wards and robbing millions from our NHS.

“NHS staff are working tirelessly to paper over the cracks, but lives are still being put on the life by staffing shortages.”

Demanding action from the Scottish Government, she said there needs to be a “real workforce plan” put in place to “ensure all services have the staff they need”.

Scottish Liberal Democrat leader Alex Cole-Hamilton said: “Under the SNP, Scotland’s critical care services face untold pressure.

“When so many patients cannot leave these units when they are well enough to do so, it creates blockages that radiate across the health system, from excruciating A&E waits to dangerous ambulance delays.

“It’s also costing our NHS millions.”

He praised the “goodwill and dedication” of NHS staff, but claimed: “This SNP Government have failed to give them the beds, safe staffing and resources they desperately need.”

The Scottish Government has been contacted for comment.