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AN EXTREMELY difficult and challenging winter lies ahead for health and social care within Dumfries and Galloway.

That is the warning from Dumfries and Galloway Health and Social Care Partnership, anticipating that current massive pressures will only continue to grow as we move into colder months.

Chief Officer Julie White said: “As we enter the autumn, our services are already under the sorts of pressure we might more typically expect in the deepest depths of winter.

“Over the summer we worked closely with our frontline teams to develop an ambitious plan that will help us recover from the challenges we faced throughout the pandemic. Our plan was approved by the NHS Board on Monday 3 October 2022 and sets out clear actions against six priority areas.

“These focus on how we will support our staff, improve recruitment and retention, recover and protect planned care, modernise unscheduled care, develop social care and improve the sustainability of our local system.

“However, even though we are already working to deliver against that plan, things are only likely to get more challenging as the weeks progress. And while I wish I could offer a more comforting outlook, I think that every one of us needs to be prepared for a very tough next six months.

“What will this mean for people in real terms?

“People should be aware that while we will be doing everything we can to treat those who have been waiting longest as part of our commitment to waiting times, further disruption is likely to the backlog of scheduled elective procedures as we see a continued high volume of people presenting with urgent, unscheduled and complex needs.

“Much of this disruption might be very last minute, because in every situation we will be working to provide these procedures until such time that unfolding circumstances dictate we are unable.

“If you have a health need, please assist us and those who are also in need by considering the best point to obtain support.

“In many non-emergency situations, visiting NHSInform.scot or calling NHS 24 on 111 can be a good first option.

“We’re conscious that people have been waiting a long time for procedures and appointments. Meanwhile, others have waiting to hear back for longer than they should in relation to concerns and complaints. We’re working to keep people updated and we appreciate continued patience.

“Within social care, we continue to face a very significant challenge in meeting the volume of need. Staff who provide care at home services are such a vital part of the whole health and social care system, and we simply don’t have enough of them.

“Similarly, residential care provided by independent providers within the partnership is another area of great challenge, as the volume of need continues to grow faster than our resources.

“And it would all be impossible without the thousands of unpaid Carers in our region. Their vital role needs to be recognised along with the very great pressures they will also be facing this winter.

“We face all of this amid a marked and growing increase in costs, with a recurring £20 million deficit within the Health and Social Care Partnership’s budget, and with the prospect of even greater financial challenges over the next three years.

“For the staff across health and social care, this will be an extremely challenging winter, following on from the stresses of the last three years which should already have been enough to break any system.

“We will continue to rely on our staff and their tireless, professional efforts to provide the highest quality care, but we must all be realistic to the challenges that we face as a region.”

EXTREME pressures are currently challenging the health and social care systems across Dumfries and Galloway. 

Urgent meetings have been taking place among clinical and care managers, as they work to address both the pressing short-term issues and the prospect of very serious challenges heading into the winter months. 

In a bid to try and manage the current pressures which include increased demand and staffing shortages exacerbated by the pandemic, a decision has been made to scale back elective clinical procedures scheduled to take place at Dumfries and Galloway Royal Infirmary over the next two weeks. However, urgent and cancer procedures will go ahead. 

A bid to convey the scale of the challenges facing everything from care at home services to hospitals comes as Dumfries and Galloway Health and Social Care Partnership Chief Officer Julie White delivers a sober message to its incredibly hard working and resilient staff and volunteers. 

In her message, Mrs White said: “It’s been an incredibly difficult 18 months for everyone, where we’ve all felt the impact of COVID-19 in just about every aspect of our lives. Right now, significant pressures are facing our Health and Social Care Partnership as we head into the most challenging winter period ever faced.” 

Addressing the current challenges, Mrs White said: “For a number of years the health and social care partnership has faced the dual challenge of increasing demand against the backdrop of difficulties around recruitment to the workforce. 

“The pandemic has only served to accelerate this problem. Many people have avoided seeking help because of COVID, have been confronted with delays, or have been isolating at home – becoming weaker or more frail.   

“As has long been the case, recruitment to jobs within the area remains a challenge, but encouraging, innovative approaches are being driven forward which do provide hope for an improved situation going forward. 

“However, right now we’re in a position where problems stored up during the pandemic are really biting. 

“Staff across the whole of the health and social care system are incredibly stretched, and we’re desperately short on the care staff who can help support people in the environment that’s right for them – such as the comfort and familiarity of their own home. 

“I was incredibly heartened to see the announcement this week that pay for care at home staff is set to increase. These carers are the largely unsung heroes of our communities, providing support, help and comfort to so many of the most vulnerable people in our region. 

“We desperately need more people to embark into this as a career which should see them better rewarded and celebrated. We are currently in the process of developing a far-reaching recruitment aimed at significantly increasing care at home capacity. 

“However, in the short term, we face real challenges providing care and support to our population in a system that has been radically changed by the consequences of managing the pandemic.” 

• A request is being made for people to first and foremost understand and appreciate the enormity of the challenge facing the health and social care system. 

• Beyond that, an ask is being made to understand that difficult decisions have been taken to address the pressures across the system, including for example the decision to scale down elective procedures, decisions in extremis to have two patients within a limited number of rooms within DGRI, to maximise capacity within cottage hospitals as staffing allows, and decisions to place people in alternative NHS and care facilities whilst awaiting support in their own home. 

• Getting to this stage in the pandemic has relied on the region’s communities supporting services, and being tolerant and patient as we adjust systems to respond to the greatest need. Whilst we recognise that delays to treatment or disruption to care will lead to frustrations, please appreciate that this is also felt very acutely by the staff seeking to provide treatment and care. Civility and support in all circumstances is greatly appreciated. 

• Finally, an invitation is being extended to help maximise the provision of treatment and care. Anyone with a loved one requiring care who can offer help or suggestions as to how we best meet the needs of their loved one is encouraged to take up a conversation with that person’s Social Work representative. 

Mrs White said: “I have never seen health and social care systems in our region under so much pressure, and unfortunately this level of pressure may continue for some time to come. 

“We really want everyone to have an insight and understanding as to just how challenging things have become through a combination of factors fuelled further by the pandemic. 

“Our responsibility is to the people of Dumfries and Galloway, and whilst the situation remains extremely challenging we are investing significantly in order to address the workforce challenges in particular to ensure that we are in the best position to meet people’s needs. 

“Anyone requiring help should not be deterred from coming forward, but to try and ensure they pursue the most appropriate means of help in the first instance from a range of options – be that a visit to their community pharmacist, visiting the NHS Inform website, contacting their GP practice, calling NHS 24 on 111 or dialling 999 in the case of an emergency.” 

The Unaudited Draft Dumfries and Galloway Integration Joint Board (IJB) Annual Accounts for 2020/21 are now out for public consultation. 

The IJB was established as a body corporate by order of the Scottish Ministers on 3 October 2015 as part of the establishment of the framework for the integration of Health and Social Care in Scotland under the Public Bodies (Joint Working) (Scotland) Act 2014.  

The IJB has responsibility for the strategic planning and delivery of a defined range of Health and Adult Social Care services for the residents of Dumfries and Galloway.  

The Draft Annual Accounts for 2020/21 opens with an overview of the key messages in relation to the objectives and strategy of Dumfries and Galloway Integration Joint Board (the IJB) and its financial performance for the year ended 31st March 2021.  

It also provides an indication of the risks and challenges which may impact upon the finances of the IJB in the future. 

The Draft Annual Accounts for 2020/21 can be read by visitinghttps://dghscp.co.uk/useful-documents/ 

Any comments should be sent to the email address katy.kerr@nhs.scot by the end of July 29 2021.