Delayed discharges continuing to put pressure on hospital system
MORE than 40 per cent of beds in the Gilbert Bain Hospital in Lerwick were occupied by people delayed in being discharged at one point recently, a meeting has heard.
Delayed discharges have been an ongoing challenge in Shetland for many years, and a meeting of the isles’ heath board this week has heard that they continue to put pressure on the hospital system.
Delays tend to be driven by constraints with capacity in care settings.
Figures show there were 17 people waiting for more than a fortnight to be discharged from hospital to a more appropriate care setting in the first quarter of 2026/27.
The report to board members said: “The social work and social care system in Shetland remains under sustained pressure, with only 0-3 residential care beds available at any time over the past 2+ years.”
NHS Shetland’s head of planning Lucy Flaws said the health board has come out of a period of “significant pressure” within the hospital in the last few weeks.
She told a meeting of the health board on Tuesday that at one point upwards of 40 per cent of bed capacity was taken by people delayed in hospital.
It came after board member Joe Higgins asked how services were preparing to mitigate the issue going into winter.
He also sought reassurance that wider public sector reform proposals are not going to put any obstacles in the way.
Flaws said work continues on trying to look at alternatives to hospital admission, including through schemes like discharge without delay, hospital at home and frailty at the front door.
“All of that is within the constraints of the social care capacity that’s available and the strategic challenges,” she added, pointing to issues like workforce supply and housing for locums and agency staff.
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“It’s a really, really tough balance. The teams are doing all of the things that they can be doing.”
Flaws also said that there is collaborative work going into the winter to try to see pressures “a little bit sooner” by making “in-time data” more visible.
Director of community health and social care Jo Robinson meanwhile said “everyone is aware of the demographics”, with Shetland having an ageing population.
She also pointed to the ongoing work to explore a new sustainable model for adult social care in Shetland.
NHS Shetland chair Gary Robinson said he was grateful for the “interface” the health board has with social care provider Shetland Islands Council, “because I think we very much view delayed discharges as a shared challenge, rather than somebody’s problem”.
He also praised the help given by the Scottish Ambulance Service, highlighting the work undertaken on assessing if a patient needs to come to hospital.
Robinson said this has now even extended through a new pilot scheme which gives paramedics portable diagnostic devices.
NHS Shetland chief executive Brian Chittick meanwhile said both the Gilbert Bain Hospital’s A&E department, and the new walk-in clinic in Lerwick, have been busy.
Up to 100 people a week have been attending the walk-in clinic, with up to 180 folk going to A&E as well, the meeting heard.
“There’s a lot of need now being met by the various aspects,” Chittick said.
“There is a lot of work happening in the community as well, at the front door in the acute system as well, and I think it’s just indicative of a busy system.”
Board member Colin Campbell also praised the hospital at home scheme, which in June saw 124 bed days delivered through having patients at home.
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