Published: 07/03/2002, Volume II2, No. 5795 Page 6

Local authorities and health boards in Scotland have been warned that they face 'tough action' if they fail to perform on delayed discharge.

Each area will have to draw up detailed plans for tackling the issue before they get a share of£20m to be invested in local authority/health board partnerships, Scottish health minister Malcolm Chisholm said on Tuesday.

The Scottish Executive will monitor performance closely and take action if partnerships do not work. This may involve sending in what it calls 'top-level hit squads' to drive through improvements. The money - which will be ringfenced - could be withdrawn in future years if this year's funding is not spent for its intended purpose, the Executive said.

Mr Chisholm said that at least 1,000 extra care packages would be created by April 2003. He said: 'Previous initiatives to tackle delayed discharge have simply not delivered the improvements we all want to see.

'This action plan is very different.

It sends a very clear signal to both the NHS and local authorities of how serious this problem is - and how seriously we will act ifprogress is not delivered.'

The announcement of extra resources came just in time for the UK's newest private finance initiative hospital, Edinburgh Royal Infirmary, due to open over the next two years.

Managers had feared that on current figures at least 60 patients awaiting discharge would have to be moved to the new building.

Last week Alison Williams, general manager for medical services at Lothian University Hospitals trust, confirmed that managers had not made provision for bedblocking when calculating bed numbers for the new site.

She said that five years ago, they thought that by now the problem of bed-blocking would no longer exist. They had been too 'optimistic', she said.

Mrs Williams, who joined the trust 18 months ago, said other unforeseen circumstances, including the buoyant Edinburgh property market. Closure of private care homes, had exacerbated the problem, she said.

'One of the unknowns at the time was the nursing home market.

Many owners of smaller homes have sold them rather than make the changes required by new legislation.'