Minister will hear care concerns

Residents face unnecessary trips to accident and emergency

Scotland's deputy health minister has promised to listen to concerns that elderly care home residents are being sent to casualty departments to die.

There are said to be difficulties in getting GPs to visit their bedsides.

The problem has arisen since GPs opted out of providing out-of-hours care and NHS 24 began to handle all calls.

Deputy Health Minister Lewis Macdonald will meet care home representatives on Tuesday, but said he believed the issue had been resolved.

He said there was now a system where GPs could inform the NHS of potential problems, so that calls could be referred straight to out-of-hours services.

Quite frankly it was inhumane, some of these patients being taken out of their bed and taken to an A&E department Bill Morrison A&E consultant

He said: "People should not be taken to A&E if it's not an accident or an emergency, or if they are indeed in a condition where what they require is care in their own bed.

"The provision that we have put in place will mean that that should not be necessary and should not be done."

There are roughly 1,500 care homes in Scotland which look after about 38,000 residents.

Scottish Care, which represents about 800 of the homes, has highlighted weekends as the most difficult time.

Chairman Joe Campbell told BBC Scotland that since GPs had opted out of working out-of-hours, care home staff have had to call medical helpline NHS 24 for a doctor.

'Extremely ill'

He said: "The system at weekends is particularly difficult because NHS 24 is feeling its way and we do find it extremely difficult on occasions to get doctors to come to patients who are extremely ill.

"What we are having to do, very reluctantly, is to take some of these elderly people from their beds in nursing homes and residential homes and take them to accident and emergency establishments at hospitals."

Bill Morrison, a consultant at the accident and emergency department in Dundee's Ninewells hospital, said that until recently it was a common occurrence to have elderly patients brought in.

We can get the most appropriate care for these patients Dr Joyce Meikle

He said: "We had a range of patients from those who really did not have any significant medical problems at all, to those who were dying.

"Quite frankly it was inhumane, some of these patients being taken out of their bed, where they were comfortable and where the clinical course should have been allowed to run naturally, and taken to an A&E department.

"I use the word inhumane advisedly. It upset the staff here a great deal and relatives of these individuals."

In Tayside, the health board admitted there was a problem.

Dr Joyce Meikle, who works at Dundee's out-of-hours medical centre, set up a pilot scheme which by-passes NHS 24.

Difficult decisions

She said all the nursing homes in Tayside had the number of the reception at Wallacetown health centre, which deals with out-of-hours calls.

The receptionist takes details which are then passed to a doctor, who will often take the call straight away.

She said: "Sometimes the doctor can make slightly more difficult decisions as opposed to a nurse.

"We can get the most appropriate care for these patients."

However, the problem remains in other areas around Scotland.