'Bed blocking' figures five times higher than target
The number of delayed hospital discharges in Edinburgh rose sharply in early 2018.
The number of delayed discharges from Edinburgh hospitals rose sharply at the start of 2018, with one month's figures more than five times higher than the target.
In March, 267 patients were delayed in hospital despite being clinically able to leave, well above the target of 50.
Many of the patients were unable to leave hospital due to a lack of care spaces available in the community and in care homes, papers going before Edinburgh's Integration Joint Board (EIJB) said.
The high number of delayed discharges has raised concerns about patients blocking beds in the city's hospitals.
In February, more than 7000 bed days were lost as a result of patients being delayed in hospital.
A report said there were "major challenges" in the care system.
It said: "Edinburgh's level of delayed discharge is a long-standing area of concern for the Integration Joint Board and the (health and social care partnership).
"Pressures are also evident across the wider system, with large numbers of people waiting for assessments and for domiciliary care, the majority of whom are currently at home, rather than in hospital."
It continued: "The total number of people whose discharge from hospital is delayed had remained fairly stable towards the end of 2017, but increased sharply in the first three months of 2018 due to the shortfall in care at home and care home capacity."
'Too many people remain in hospital because there is a perceived risk in discharging them.'Report to IJB
A separate report noted that Edinburgh compares poorly to other partnerships in Scotland.
It said that "Too many older people are admitted to hospital when there could/should be safe and effective alternatives; and too many people remain in hospital because there is a perceived risk in discharging them.
"This risk averse culture does not take account of the risk to people of remaining in hospital when they no longer need to be there."
The health and social care partnership will consider a plan to alleviate pressures on the system at a meeting on Friday.
Judith Proctor, chief officer of Edinburgh Health and Social Care Partnership said: "Earlier this year, in recognition of the unacceptable position the EIJB has recognised, committed £4.5m in additional resources to improve, in particular, performance in terms of the number of people waiting on social care assessments in the community and, separately, the number of people waiting in hospital on care home placements.
"There are very encouraging signs on the impact this is having in these two areas and we are grateful to staff for their hard work in driving this forward and to the providers we have worked with to provide a better, more sustainable, deal for all involved."
She continued: "There is no denying that these improvements have been offset by deterioration in our performance in the provision of care at home.
"We are clear that this relates, at its root, to the recruitment and retention of staff in Edinburgh's labour market, particularly in the important role in care and we are working with care provider organisations to see how we can help them deliver in a more sustainable fashion in future. We would expect this would lead to more investment by the IJB in this area."