Medics urge Scottish Government to take action to safeguard care home sector or closures ‘will escalate’

Doctors are urging the Scottish Government to hold urgent talks over the future of the country’s care sector, amid warnings that homes are closing at the rate of one a week.

Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh (RCPE), said the body is “deeply concerned” about care home closures, warning these could impact on NHS care over the winter.

Stressing the “decline in care home capacity is felt across the whole system”, Prof Elder insisted action is needed from ministers as a “matter of urgency”.

His comments come after Scottish Care – the body which represents the independent care sector – said the “significant pressures” it faces has resulted in the “largest number of care home closures” in recent months, with a “very real fear” these will “escalate at speed”.

In a statement issued earlier this month, the organisation warned: “Every week at least one care home is closing down. Unfortunately, it is the small, rural, and remote private and charitable care homes which are not managing to continue operating.

“This is an especial risk in Scotland where most private providers are small, family-run businesses.”

Prof Elder said: “The college is deeply concerned that care homes in Scotland are closing at the rate of one every week.

“Care homes not only provide long-term care for older people but often act as a bridge from hospital to home.

“A major cause of the flow difficulties experienced in acute care in recent years has been ‘exit block’ – the difficulty in supporting patients back to their homes after hospitalisation.

“Capacity in care homes is already stretched and any further reduction will not only have an impact on the NHS Scotland’s ability to provide safe and effective care in its acute wards, but will impact on the dignity and welfare of those patients who are delayed and have to wait inappropriately for weeks or months in hospital wards.

“The impact of a decline in care home capacity is felt across the whole system – contributing to longer waits in emergency medicine and a decline in bed availability for elective surgery in hospital wards.

“Capacity issues are year-round in the Scottish NHS at this time – the winter months only see the situation worsen, hence our warning now that care home capacity must be protected in the coming months.”

With delayed discharges – where patients who are medically well enough to leave hospital have to remain on wards while they wait for care to be put in place – having reached a record high in 2022-23, Prof Elder added: “We urge the Scottish Government and local government stakeholders, as a matter of urgency, to get round the table with the independent care sector and explore all options to support it and help make it sustainable, not least in terms of tackling its very severe workforce challenges.

“We need to have a successful care home sector for both the people who require places within it and for the effective functioning of our NHS as a whole.”

A spokesperson for Cosla, the body which represents Scotland’s councils, said: “In March of this year, local government offered the highest ever increase to the National Care Home Contract rate, recognising the critical role of care homes and their staff in supporting some of the most vulnerable people in our communities.

“We are pleased that Scottish Care members have since voted to accept this offer.

“Local government remains committed to working with those who deliver, plan and commission social care support to ensure the National Care Home Contract remains fit for purpose by providing stability for the market and supporting the sustainability of care providers within an increasingly difficult environment.

“Cosla continues to work with our partners to build a health and social care system that is resilient year-round, and continuously delivers high quality, effective care and support.”

Social Care Minister Maree Todd said: “Social care services are absolutely fundamental to our communities and it’s clear how challenges like energy costs, the costs of living and Brexit have really impacted the recruitment and retention of staff.

“The RCPE and Scottish Care have raised important issues and we continue to engage with them and other partners regularly to build a more sustainable workforce that feels truly valued and properly rewarded for their work.

“We’ve increased pay and are working towards our commitment to increase spend in social care by 25% by the end of this Parliament, an increase of over £840m.

“In the long term we believe the National Care Service will help us and our partners to provide consistency in further improved pay and conditions, access to training and development and ensuring a career in social care is attractive and rewarding – but we are beginning to make those improvements now.”

She encouraged people to attend events the Scottish Government is holding this summer to discuss the care sector.