AIBU to wonder what the heck is going on in hospitals right now??

[Rinoachicken]

Before I start, I want to make it clear I am NOT blaming the hospital staff in any way.

13 hospitals have declared state of emergencies or whatever it is.

Why is everyone suddenly descending on A&E all over the country all in the same week? Has there been an outbreak of something I don't know about?

I don't get it. A&E is always stretched to the limit, but Why this sudden crisis all over the country?

Am I missing something??

Don't the CQC look at emergency admission rates as well? It isn't like there is no incentive to treat patients rather than leave them until they need urgent care. Even if many doctors did that, which I doubt is the case. The problem is not enough doctors and increased pressures and cutbacks in all sectors leading to services being squeezed and pushed onto other services which are already struggling. And there have been plenty of warnings that this was going to happen.

We're lucky in that our hospital hasn't reached crisis point yet and our department can cope with this level of work for a short period. If the hospital reaches crisis point or this level continues for a couple of weeks, things could get a lot trickier.

www.telegraph.co.uk/health/nhs/11319627/AandE-in-crisis-a-special-report.html

This is an interesting read.

I've learned such a lot from this thread, thank you especially to all the medical people who've taken the time to post, especially since you are probably exhausted after a long shift! (My mum is a nurse and I remember creeping round the house so she could sleep after a night shift).

and for you all

Despite the many problems with the NHS we are very lucky to have it my son has a rare genetic disorder which of been inherited from either myself or his dad it has caused his autism and learning difficulties ,myself and my husband had blood tests in November and we found out today neither of us carry this disorder so in my sons case it started with him I,m on a forum for family's affected by this and a lot of the parents in america said their insurance would not pay for them to have the blood tests so they would not know if the disorder could be passed on to future generations it made me realise how lucky we are !

It is not just the elderly who need support and end up in a&e, the enormous cuts to mental health services have a huge impact. For any patient who is depressed and suicidal the only place to go is a&e, there are no other services. Add to that the huge numbers of vulnerable people who have lost their mental health nurses, who don't get the support they need, who let their physical health deteriorate, who end up in a&e drunk or drugged up because of the failure of the services meant to protect them.
I work in Merseyside and one local mental health trust had its budget cut by 30%, the only safe house for people in crisis has closed, as have 3 of the centres that used to provide counselling and support.

As a patient I have also been forced to use a&e 'unnecessarily'. I have endometriosis, and have on occasion been in so much pain I have passed out. The waiting time for the operation to diagnose and treat me is 7 months, and there are no other services that can give the painkillers I need out of hours. I have ended up in a&e 5 times, and have had to be persuaded to go by the out of hours doctor every time as it is just such a waste of resources. If I had a gp who knew me, who could do households, a shot of morphine would have sorted me out at least until the next day but that just doesn't happen now.

*housecalls

I start work as a junior doctor in July, I am dreading it. The system is broken, and the frustration and anger of the staff is palpable.

Our mental health team was never brilliant to start with. It's become non existent in the last few years. It's noticeable that during my last crisis, when I was worse than I think I have ever been, my GP didn't even suggest a referral to CMHT. What I got was 6 20 min sessions of CBT over the phone. Tbf the therapist was quite honest from the start that it wasn't appropriate and that they couldn't help me. That then progresses to 16 weeks of face to face CBT with a different therapist, only then can I be referred back to CMHT to access a CPN or care coordinator who will assess where I need to go next.

And while all that is going on my GP will insist on seeing me weekly to check in, which takes up appointments that could go to other people if I was being seen weekly by a social worker or CPN.

Yes mental health nurse here our unit have lost 50 beds acute and elderly in the last few months but I,m not sure its due to budget cuts the trust has something like 50 million in savings plus the wards they have recently closed they completely refurbished less then two years ago at a cost of several million ,complete mismanagement in my opinion.

Stillwish going back to this post yesterday:

Breakingdad did you not think it was your responsibility to get your father out of there ? I wouldn't leave my parents on a hospital ward if they didn't need to be there.

Have you tried getting someone out of hospital if the powers that be won't let you? My mother has been in and out with strokes and on the last occasion was held, pretty much against her wishes, until SS had done a home check. You could say they were just being conscientious BUT, there had already been a home check 2 months previously, we had a letter outlining what aids were in the house, what her care plan (for which she is paying privately) was from a registered caring agency. So my mother, who was well enough to go home was kept on a stroke ward for 48 hours longer than necessary so someone could go and look at her house, same person who'd done it before and then say "yes, that's fine". It was utter madness and no one could be moved, it had to be done.

There was another almost as bonkers occasion which is too long to detail but it has resulted in my mother being practically hysterical if she has to go into hospital for anything, even as an outpatient as she's convinced she won't come out again.

My DS was admitted to hospital in October with suspected appendicitis. We were placed on the Children's ward (and everyone was utterly lovely to us) but then had to stay in for 4 days as he was under the care of the surgical consultant who had to do rounds for the entire hospital - so surgical wards, childrens' wards, geriatric (if they had surgery), gynae etc etc. My DS didn't have appendicitis but we were taking up a bed because there literally wasn't the staff to visit us and discharge him.

My mother worked for a bankrupt trust until last week - the hospital is in the process of closing down, no A&E there anymore only minor injuries which closes at 8pm, and this has created a huge mess at the other hospitals. When I took my DS into A&E with the abdo pain at around 4pm there were people sitting everywhere and when I went down after we'd been admitted to feed the car park meter there were still some of the same patients waiting - and this was at midnight.

It's a crying shame - and I'm glad this is all finally being brought to light - fuck this government.

Frosty we were in everyday trying to find out what needed to be done but were lead to believe he was under social services auspices, and we would be discharging without permission.

Good Lord! What would happen if there were a big train crash? Everything would have to stop for A&E to deal with that. The paper cuts and spots in eyes would have to go home.

BreakingDad I was commenting on what Stillwish had said - not on you, sorry if that wasn't clear. It can be a nightmare trying to find a way round the processes of discharge, I dread the next time my mother has to be admitted.

Hi Frosty, yes sorry on posting I realise the rest of what you had written and you had had a similar experience of them being 'detained' by social services.

The NHS money WAS THERE to make a significant difference to our future health needs i.e. significant increases in population, drunks and wrinklies, but under Labour it was squandered as little of it got to the front line, and Public Finance Initiative (debt) spending was to eat into NHS budgets for decades to come.
May 2007; “Blair's legacy: Health”
news.bbc.co.uk/1/hi/health/4555344.stm

Governments are generally pants in running their Public Sector, but some are far worse as they use taxpayers money to CREATE jobs/roles, which is why their trade unions and the Labour Party cack those pants at the very thought of ‘competition’ - as this detailed left-on-left assessment (below) confirms – but let me first quote a footnote from the link below.

[26] ‘The Institute of Health Care Managers listed 1,700 separate job categories in 1995. By 2002 this had grown to 5,529 : Jenkins, Thatcher and Sons, p. 289. Figure for internal market from Leys, ‘Reducing Social Democracy’s Last Redoubt’.

newleftreview.org/II/62/tony-wood-good-riddance-to-new-labour
“The 2000 NHS Act, meanwhile, called for a ‘mixed economy’ in healthcare, introducing ‘Independent Sector Treatment Centres’ to compete with the public sector in low-risk elective surgery, and expanding the role of private companies in primary care and community health. The same year a Concordat was signed making the use of public funds for operations in private hospitals a normal, rather than exceptional, practice.”

“What has been the impact of these changes? Though NHS funding rose significantly after 2000—on average, 7 per cent a year in real terms—the costs of creating and operating the internal market now consume 10 per cent of the total NHS budget; sizeable sums have gone on the expansion of new managerial layers.” [26]

“The need for public healthcare providers to focus on the bottom line has brought a damaging combination of staff cuts, dilution of the skill mix, and faster through-put of patients; drives to reduce waiting times have meant a rise in the number of readmissions, while cost-cutting in subcontracted services has brought declining standards of hygiene. “

“While PFI has resulted in new facilities being built, their construction has been guided by the rationalities of investment rather than medical assessment of the population’s needs; in some cases they are too small to serve the area for which they were supposedly built. Most damagingly, payments to PFI investors are locked in for a generation or more— a long-term drain on resources out of all proportion to the short-term gains. ”
www.telegraph.co.uk/health/healthnews/9356942/Blair-defends-PFI-as-NHS-trusts-face-bankruptcy.html

“The characteristic paradox of New Labour’s record in healthcare is that, by 2008, there were 13,000 fewer general and acute beds than in 1999, while a ‘burgeoning market of alternative providers’ has developed, ready to draw personnel and resources away from the NHS.”

And Labour’s Mr Burnham, Health Secretary during the last Labour administration, seeing the 2-3 million migrants come in TO HELP PAY/SUPPORT our aging, is the man to be trusted now the money is tight and we need smarter government to do more for less? P-lease.

WE needed to get IN FRONT of these problems when we had the money, and increasing clinical staff an average 3% a year KNOWING our 2-3 million population growth and aging demographic, was incompetent government.
www.telegraph.co.uk/health/healthnews/7520408/Rise-in-NHS-managers-outstrips-doctors-and-nurses.html

IMO the PFI monsters are eating into the NHS budgets now causing problems with funding. Also, I think some of the processes within the NHS are out of date. As a patient my new GP is closed right now. They are open 6am-9am and 5pm-10pm. It makes a lot of sense and guess what.... nearly all the doctors are parents who are able to keep working around the other income earners schedule. The paediatrician group we use is available 24/7. If my children are sick in the middle of the night I can speak to a doctor from the practice we use who will advise us on what to do. Out of the twenty or so times we have called in the past 3 years we have only ended up in hospital once. Other times they were able to write an escript which I picked up from the pharmacy or was delivered if I wasn't able to get out of the house (very pregnant that time with 2ft of snow so pharmacist arranged delivery).

Also, here in the US they have a lot more specialists so, for example, when in labor the L&D ward had someone able to attend theatre and one running around giving epidurals. Once given an epidural I was monitored remotely by one nurse watching everything from a screen. My friend had an epidural in the UK and the midwife was then 1-1 with her with constant checks. It was a very inefficient use of midwifes time.

Don't get me started on the admin. I carry a credit card with me with my medical insurance details on it. If I go to the hospital my GP is affiliated with the hospital are able to pull up my records by swiping my card and my GP gets a message via text that I am in hospital. I have not had a written script for years and when I transferred the kids medical records to the new group the old group emailed them to the new group. This was completed while I was on the phone with them. Don't get me started on the huge inefficiency that is booking appointments with demi-god consultants. Why a letter is needed is beyond me. You have an admin person answer the phone and book people into open slots that suit their schedule. Far less cancellations this way. My GP's office is able to book appointments with specialists at the affiliated hospital. If people don't cancel within 24 hours of their appointment they should have to pay a fine.

All these little things add up to less being available for all. Oh and they need many more medical students. Why you need to be a superstar academic to get into medical school is beyond me. Best doctors are ones that listen. Ive been seen by plenty of doctors here in the US who are not straight A students and the care has been excellent.

Just seen this thread and have a few points:

No, the declaration of major incident gets the hospitals absolutely no slack with other targets. In fact the cancellation of surgery and the diversion of staff to deal with the pressure coming in the door will mean the hospitals most badly affected will miss more targets and will be getting their arses kicked later in the year for that reason.

Yes winter is a bad time for hospitals and yes this winter has not seen severe weather and epidemics (yet) - although there are a lot of chesty respiratory things out there. This does not mean that hospitals should be cruising through because the unfortunate truth is it's 'winter' all year round now and it's because of the volume of older people coming in to hospital and the reduction in capacity to manage those older people when they get out. That's because of cuts to social care but also I believe because of a reluctance on the part of families to fully assume responsibility for older patients. Which brings me to the role of family....

If families could try constructively engaging with hospital staff, putting themselves out to take responsibility for their relatives and accepting that their relative is their responsibility too, things would be considerably better. Lots of families do do this. Lots of mumsnetters will be doing this but not all and 'dump a granny' season which is mentioned in the Telegraph article below is a real problem. It's not that common but it happens and it never should.

Morebeta's conspiracy theory is of course total bollocks btw. The crisis is political - but it's caused by political decisions not engineered for political capital.

Mumzy Wed 07-Jan-15 19:58:32
7) oh and all the drunks who frequent A& E. Last time I went to A&E 3/4 of all the patients was there due to some drink related problem. One woman came in as she had a gashed head due to a drunk throwing a bottle at her!

In which case she was the victim of an assault so why are you blaming her. If it had been a child knocked down by a drunk driver would you have blamed the child

I had a similar attitude from an ex employer. My H has COPD Heart problems arthritis and she called him a malingerer. A colleuges 8 year old daughter who was ill didnt get this attitude shown though.

northern lurker as a carer i find those "dump a granny" comments extremely offensive. As will other family carers i should imagine.

Carers and families are being criticized and blamed. These are people who are on the paltry amount that is Carers Allowance and/or working in a low wage job. Employment rights are being eroded and now you cant claim for unfair dismissal until you have been working for 2 years. It is entirely at the discretion of the employer. In the same way that parents who can ask for flexible working wont necessarily get it. How many parents here would like it if i went onto a thread about the right to ask for flexible working and told them you are not trying hard enough to assert this "right"

Hi - I'm a adult social worker working in a large town in Yorkshire - over Christmas we had so many hospital discharges to deal with - older people requiring care placements mainly - the local authorities rates that we pay to fund people in care placements is not accepted in 95percent of the residential/ nursing homes in the area due to mainly greedy providers who can charge what they want. We were pressurised to get people out as we are fined should health declare people medically fit to be discharged yet there are no placements and this backlog caused a lot of the mayhem

Flu. And pneumonia. I work on a care of the elderly ward and it is rife.

I was too busy to get my flu jab this year, but wish I had. I have a feeling the uptake for the flu jab thus year was low - have no official evidence but that is just the impression I get from talking to staff and patients.

If you read my post properly you will see I was referring to a phrase used in the article mentioned and linked below. However of course it's offensive. It should be. It describes terrible behaviour on the part of some 'carers' and it does really happen. It's not a myth. We should be offended that some families behave in that way. It's not about the employment status or financial position of those families. There are plenty of people absolutely run ragged between elderly relatives and their work and other responsibilities. They have my sympathy. But there is a minority who don't and who see their elderly relative as entirely the responsibility of hospital staff and who happily countenance a relative being kept in hospital instead of at home because it makes their life easier. I'm sure that isn't you. I'm glad you've never met those people but they are out there believe me.

Flu and/or a nasty bug ARE reasons to go to a&e for elderly people btw, they can be deadly.

And as elderly people make up a huge proportion of the population in many areas, then of course when there are "nasty bugs" going around, hospitals will be stretched.

But agree that if you are a young fit person, you should not be going to a&e - you should see your ooh dr or gp.

I have heard of cases of young people getting nasty pneumonias this year though.

And fwiw I don't see families dumping their relatives in hospital as such. I have seen cases of discharges being delayed by their usual carers being ill themselves in hospital, or having injured their back/shoulder and being unable to cope. Therefore a discharge is unsafe and extra care needs to be arranged, which takes time.