bed blockers adding to the lack of hospital beds

[newcovidisolations]

My mum was medically discharged to leave hospital into rehab (following a stroke) well over a month ago but due to no rehab beds being available she is still taking a hospital bed from someone who needs to be admitted from a&e. She has now tested positive for covid and despite no symptoms at all is now taking a private room on the ward for 7 days as they insist she isolates.

Over 3 weeks ago I rang every private rehab within 50 miles and none could assess her to see if she could transfer until 5th Jan. Despite fees of over £2k per week with extra charges for all physio.

She could possibly have regained mobility with daily physio in rehab had she been discharged weeks ago whereas now she could have far more care needs for the rest of her life.

The system appears broken to me and could affect any one of us and I cant understand the lack of protests. Any of us could need the hospital bed not just the elderly. Her ward is not just used for strokes.

Social housing has a lot to do with bed blocking, my exh was stuck in hospital for 10 months that he was fit to leave in except for the fact he hadn't an adapted home, my late best friend was stuck in for 6 months after losing her leg again because she had no adapted home to go to.

But a lot of elderly people in hospital will present like that BECAUSE THEY’RE ILL. (Just like my 50 year old husband presented when very ill in hospital). My fit, totally independent no dementia, father had a small heart attack, fell, knocked himself out and was on the floor a good while. By the time we got him to hospital and through 38 hours on a trolley in A&E he had sepsis and a kidney infection. He was tired, confused and not himself. He was treated pretty poorly, like some old fogey, discharged twice with sepsis (cue two more long ambulances and two more waits in A&E that made him even more tired and run down). He caught MRSA, C-diff and Covid while in hospital. He had sores on his bottom that were awful because he was unable to reach his pee pot and wet himself. His call bell was left out of reach too. He fell off his chair because he was trying to move off his raw skin patch. Nobody found him for an hour (side room). He was treated like a nuisance, a bed blocker, but most of his issues stemmed from his care. He never got better. Died in hospital. Largely down to the hospital and it’s treatment of the elderly. The NHS is already culling the elderly imo.

@Honeyroar so sorry to hear that but your experience sounds just like mine and this is the result I fear.

We have two in my trust.

How can that be?

Almost all countries/individuals suffered/benefited from all of that, yet the issues facing the NHS are unique to the UK.

Can you link to 500 people a week dying needlessly because they cannot access healthcare in other European countries? or 4 day waits to access AE or a ward?

To put that number in perspective, thats far more civilians than die in Ukraine each week.

Brexitiers need to accept that they helped cause this, they voted to make it very difficult for EU carers to either want to stay in the UK or come here... You need the 250 fee & have 1250 in the bank..just for 3 years and similar amounts for partner and children.... its a fucking mw job, they can go and work anywhere in 27 EU countries for free.

There are some healthcare issues which seem to be present in other countries. US, Canada and Oz are certainly facing chronic shortages of healthcare staff- mainly nurses. The NHS is faring particularly badly though as it was already cut to the bone, there's no give in the system to cope with this increased demand.

@America12 wards where the elderly are not expected to be discharged at any point in the future ?

@helford I don't understand why you replied to my reply with your post?

@Almostwelsh I agree with you about the moral issue re taking other countries workers. I think we will see more of our "young" emigrating which of course exacerbates the problems.

@SommerTen HCA's are the unsung heroes of the NHS. You deserve double what you get paid. x

@BirmaBrite No, my mother did not have a care package- she was living independently, driving her car, and a few days before being admitted to hospital marched 2 miles for some shopping because she "likes to get exercise". Her healthy living style has meant she was rushing around doing voluntary work in her mid 80's, so to go from being that independent to being on a fall alarm so she couldn't even reach something for her bedside table didn't go down well with her.

What my DM needs is a week or so in a convalescent home (I imagine no such thing exists now) where someone can check she's taking the right medication, that she's drinking and she's eating something. She is very resistant to carers coming in (and I'm sure she won't need them in a few weeks) but if it was a "this is what the Hospital recommend on discharge" and it was means tested it would be ideal. My DM can afford it and would buy into it, if a care package were "prescribed" by the hospital.

It's not about age, it's about bed blocking. Anyone who doesn't have adequate support at home can end up bed blocking. It's more likely to be the elderly because they live alone.

If my mother hadn't ensured her children were well educated and encouraged them to go far and wide in the world, maybe she'd now have several DC living round the corner at her beck at call. Or if she'd lived an unhealthy life style she may have already dropped dead. It seems she's a victim of her own success

Maybe it's to do with a wider phenomena of women no longer being willing to do difficult and stressful work for low pay?

Maybe, but it's also the changing face of healthcare.

The people that were in hospital 50 years ago, mostly wouldn't be in hospital today - they'd be treated as outpatients or in the community. Heart attack patients are an excellent example of this, no more six weeks of bed rest.

The people that are in hospital today, mostly wouldn't have been in hospital 50 years ago - they'd be dead. Particularly geriatric patients.

Modern medicine is much better at keeping people alive for longer. It's very good at keeping people alive for longer in very poor health and/or at lower qualities of life that require very high care inputs.

Thanks for your reply, it sounds as if we have ( inadvertently) created a situation whereby advances in healthcare translate into 'making a rod for our own backs'?

There have been a few threads on DTOCs and the current state of the NHS on MN the last few weeks. Something that's come out of most of them is that there's a need for a public discussion on:

• What we want as a society from a health and social care system; and
• What we're prepared to pay for in terms of health and social care; and
• The role of Quality Of Life in determining the funding of health and social care.

To date there's been a general policy from all political directions to fund healthcare come what may. But in the absence of funded social care it's reaching the point of diminishing returns when there's no capacity to get patients out of the other end of the sausage machine because there's no social care to pick them up once the medical needs have been addressed.

Ex carer chipping in here. I left the job a year ago at the same time as two of my colleagues, and it all came down to the same thing.

We just couldn't make ends meet.
The company that we worked for had a principle of a small pool of carers for each client so a lot of visits for a few clients (less spread out).
Great in theory but if Mrs Jones goes into hospital that's up to half your wages gone with no warning, unless they reallocate you, which they didn't.

That's not sustainable in any job.

Maybe we need to follow the childcare model and ask the client to pay a retainer which goes to the carer, until they come home or terminate the package?

Just a thought.

Or maybe just ban zero hours contracts and give these workers a reliable salary which they have a right to expect.

To date there's been a general policy from all political directions to fund healthcare come what may.

Yes, but only up to a point - if we had the same numbers of hospital beds, nurses and doctors relative to the population, as the best of Europe like Germany, there wouldn’t be the same intense pressures as there are now on the NHS?

Or maybe just ban zero hours contracts and give these workers a reliable salary which they have a right to expect
Does this link in with the lack of overseas workers available to work in social care? What I mean is the overseas workers were easier to exploit, so social care relied on a large pool of workers who were easy to exploit and without that it falls over?

AngieBolan sorry I misread your orginal post, I thought your Mum had the fall alarm at home !

I do think that Government need to have a think about introducing some sort of paid leave for people with Elderly parents/relatives, so that people can be discharged home more easily and relatives don't end up financially out of pocket by supporting the discharge.
Most Trust's have some sort of supported discharge scheme and social services runs an additional service in my area, both sound ideal for your Mum, the aim is to get people back home, with a little bit of short term help until they are back to their norm. They can also assess if they need any equipment or input long term.

My DD worked as a carer, whilst at Uni, now in NHS, she would say she was treated better as a carer by her agency than by the NHS and the work load they have put her under.... less money but better working conditions and this was during covid.

She never felt exploited by the agency and neither were the EU workers she worked alongside, who have now left.... either CV or Brexit.
UK Govt exploited them all....an example would be HMRC mileage rates, which lag 6months behind pump prices and don't include motorway prices.... carers cannot afford to carry this.

The UK set employment law and EU workers in care work were not exploited more than UK citizens.

Not really , waiting for packages of care which can take months.

You missed the rest of the post. A political focus that concentrates on funding treatment without funding the support framework (which includes nursing staff, beds and social care) creates the problem.

You may also have missed the trouble and scandals over healthcare in Germany the last few months.

You may also have missed the trouble and scandals over healthcare in Germany the last few months.

I am aware the German health care system has its problems; but I just checked the figures with the Kings Fund website

www.kingsfund.org.uk/publications/nhs-hospital-bed-numbers

According to that, there were 299,000 beds in 1987/8 and there were 141,000 in 2019; approximately half. Likewise Germany had 7.91 beds compared to the UK’s 2.45 per hundred thousand. If we had 7.91 beds per hundred thousand, the NHS wouldn’t be under the same pressures as it now?

I also believe the NHS creates problems in social care; it’s not just a victim of underfunding in social care. Look at the problem of giving elderly people catheters, because nurses don’t have time to help them with the toilet - once they have lost muscle control and are incontinent, they need a care home place at £6,000 pcm for the rest of their lives? There is no triage in our local A & E - people with a potentially unstable head, neck or back injury are left to sit in the waiting room for 5+ hours, before they see a doctor. (A HCA takes their blood pressure, pulse and temperature after about 4 hours, but they don’t ask about symptoms) Couldn’t some patients suffer life changing injuries in the waiting room - which is likely to cost a shed load in care in the long term?

Same here.
1997/8 my county health services closed 6 or 7 community hospitals, some 660 beds lost. Apparently jointly-funded by health and social care community teams were supposed to help keep people out of hospital/prevent unnecessary admissions.
That ceased to work when the two spectacularly fell out - not a complete surprise when theirs funding pressures/different criteria for services (free at point of access vv means tested) etc.
Hardly a surprise there’s the catastrophic situation we have now as that was replicated across the country.
Continuing chucking money at it isn’t achieving anything but I have no idea what would ☹️

YY @Nat6999 Housing associations dont want to deal with the problem either. Their answer is to tell the tenant to move to a non existent adapted home elsewhere.