Chamber and committees

Good morning. I imagine that working at the state hospital can differ greatly from working in other health boards. In your opinion, what particular pressures do staff at the state hospital face, how is that likely to affect their wellbeing, and what steps is the board taking to address that?

That is great—thank you.

I will come back on that briefly, convener—

That is great, thank you.

Absolutely. We also encourage sporting figures to be more open about stress, anxiety and depression; we have come a long way in that. People who have those mental health conditions may not necessarily come under Scottish Disability Sport’s remit, but will participate in organised sport and other physical activity. How do we better support people who have specific diagnoses? I am thinking in particular of people who have bipolar disorders, schizophrenia or personality disorders, about which there is less understanding and awareness. How do we ensure that those people are welcome in sport and that they are understood by their team mates, coaches and others in order to ensure that they can get the best support out of what they are doing? David Ferguson is nodding, so I will go to him.

As we have heard, the hospital at home programme allows patients to receive acute care in their own home or in a homely setting. The success of the service has clearly shown that it alleviates pressure on unscheduled acute care in hospitals by reducing admissions. Between April 2022 and March 2023, 11,686 patients were supported by hospital at home services. That is a 53 per cent increase on the previous year. Healthcare Improvement Scotland has said that the equivalent emergency admissions to in-patient hospitals might have equated to significantly more occupied-bed days due to the likelihood of delayed discharges.

Furthermore, hospital at home is now growing and is the fifth-biggest hospital for older emergency in-patients, with the number of people benefiting from the service being similar to the latest published numbers of people aged 65 or over who were admitted as emergency in-patients to Aberdeen royal infirmary or Victoria hospital in Kirkcaldy.

As I have said, hospital at home services are clearly reducing pressure on accident and emergency departments and the Scottish Ambulance Service, but they can also vastly improve the patient experience. That is what I would like to focus on in the rest of my contribution.

Hospital at home has high rates of satisfaction and patient preference across a range of measures. We can see that from the increased demand that I referred to earlier. It allows people to be cared for in their own home, where they are comfortable, where family and friends can easily visit them, and where their things are—their home comforts, pets and the other things that we all take for granted, until they are not there. That impact cannot have a price tag put on it. We often lose humanity for individuals when we talk about large-scale programmes.

In hospital at home services, care is co-ordinated in the community by GPs and district nurses, so they ensure continuity of care and the building of positive relationships between patients and healthcare staff.

I can say that such closures absolutely would do that.

The programme can also positively impact on social care delivery. Patients losing their care packages due to hospital admission can lead to delayed discharges, and patients can be stuck in hospital when they do not need to be. We know that longer stays in hospital can lead to increased frailty in older patients. By preventing hospital admissions, the hospital at home service enables patients to keep existing agreements with carers who visit their home to help with essential needs. That, too, maintains continuity of care and allows people to build relationships with their carers, which can be of great comfort to vulnerable patients.

I want to read one testimony from within my region, which was posted on the Care Opinion website. It demonstrates the positive impact that hospital at home can have on patients. The testimony said:

“I would like to thank the H@H team in Coatbridge for the level of care from the team which exceeded mine and my mums expectations. The care and attention can only be described as excellent.

Not only did this prevent my mum having to go into hospital on two occasions but the communication, advice and support from the team not only helped my mum but gave me the confidence that I was treating her to the best of my ability.”

That testimony clearly shows how hospital at home and the incredible teams that work in the service can improve patients’ experiences and provide comfort and stability when people are unwell.

More broadly, the Health and Social Care Alliance Scotland has said that the hospital at home service reflects a positive change in the culture of how health and social care is delivered, by focusing on shared decision making and delivering the personalised outcomes that matter to individuals and their families. It enables more person-centred care, which empowers patients to make choices about their care in an environment that is safe and familiar to them.

Although hospital at home services alone will not eliminate pressure on acute services, they will form a vital part of a wider system transformation that aims to reduce hospital admissions and ensure that more people can be treated at home or in a homely setting.

The consultation analysis report on energy drinks highlights that respondents suggested that there was a need to focus on education about energy drinks, on the labelling of energy drinks and on providing an easily understood and straightforward definition of energy drinks and the drinks that that definition would capture. What action is being taken to address those concerns?

Do you want to add to that, Gordon?

What actions could be taken to better enable women and girls with disabilities to take part in sport and physical activity? I ask Lynne Glen to respond first, if that is okay.