What’s the answer to ‘bed blocking’?

[Cuppasoupmonster]

Another day, another article about ‘bed blockers’ (put in speech marks because I know it’s a bit of a goady term).

I was shocked to find out a third of beds are taken up by ‘social patients’ in some trusts, who are medically fine to be discharged but can’t be because the care they need afterwards isn’t in place. I feel irate that the whole point of lockdowns to ‘stop the NHS from being overwhelmed’ needn’t have happened if it wasn’t overwhelmed in this way to start with.

Whats the answer? Early intervention so they don’t end up in hospital in the first place? A rise in taxes to pay for more services? I’m not sure the working population can afford to pay more tax.

The ‘ageing population’ issue means this can surely only get worse?

That makes no sense. She went into hospital for a planned minor procedure not as the result of an accident at home.

Whilst in hospital she was dropped by the staff which resulted in her no longer being independently mobile. In the time she’s been home with her team of carers and family support she hasn’t had a single fall.

Why should she go into a care home against her will ‘just in case’?

FFS, there is a lot of effort to keep people in their homes.

That's what it should say.

@Walkingthedog46
Has he got home ok or has the support he needed?
There's sometimes a gap between consultant saying something and an actual referral by time consultant "asks a nurse" to refer and that nurse actually refers.

Was your husband younger and in a community rehab hospital bed or an acute hospital as that makes a difference for cover

Anyway hope he got home or supported with the right level. Complex assessments are harder than D2A ones

Once Labour get into power, the problem will be sorted😳

I think the whole system needs an overhaul plus pay staff more which means tax etc go up

No easy solution whoever is in No 10 😳

www.who.int/data/gho/data/indicators/indicator-details/GHO/hospital-beds-(per-10-000-population)

All countries have reduced the number of hospital beds as illnesses which were once death sentences became more easily treatable.

Joined-up policies are possible, politicians of all stripes seem to subscribe to a perverse view of capitalism where excess profits are acceptable but businesses are protected from their own foolishness. Energy arbitrage businesses have been bailed out, the casino actuaries in the pension companies have been bailed out, only the taxpayer ever has to pay full price.

At present, the opposition don't seem terribly keen on seeking power and it has been a very long time since any politician put forward coherent, costed plans to fix the issues that face the country.

And to people saying that essentially the NHS should wash their hands of the whole thing and if you're medically fit to be discharged then that is what will happen, the reason that's not the case is because it's in nobody's interest to send large numbers of people home just to readmit then within a few days. The whole point is to prevent unnecessary returns to hospital.

Everyone is very good at gestures like clapping and platitudes. I ❤️NHS and 🌈 etc
Not so good at holding Their MP to account, supporting better funding, appropriate use of services
Quick to stereotype and malign staff

• at least they have got a job
• it’s a vocation
• gold plated pension
• They’re over paid

'Relatives stepping up' is code for 'unpaid female labour'.

cant presume or assume relatives will or can “step up”
assumption is the female relative will do the literal heavy lifting

@Tiani4

You keep implying I'm making it up, which is a bit odd. Despite others saying it's true of their areas too

At least 1/3 of hospital inpatients do not require acute hospital care. And a large proportion of that 1/3 are waiting on poc.

For months.

news.stv.tv/scotland/scottish-government-called-upon-by-charity-age-scotland-to-take-action-over-delayed-discharges-from-hospital

www.publichealthscotland.scot/publications/delayed-discharges-in-nhsscotland-monthly/delayed-discharges-in-nhsscotland-monthly-figures-for-august-2022/#section-2

I dont have stats for my actual area and wouldn't post them if I did so you will just have to take my word for it.

@viques

I agree, there needs to be an interim place of care that frees up hospital beds before care at home can be sorted..,

There are though -they are called discharge to assess D2A beds MDT reablement beds , step down beds and now step up beds in some areas. Huge investments dyeing covid abs post covid

The delays are in community of impact on disability through other delayed treatments and kick on impact from influx of post covid work . There has been huge moving on from hospital investment In Services & beds with MDTs (multi disciplinary teams) though across England and Wales (and presumably Scotland) for the past 2.5 years and continuing. It's not a prefect system but it has been phenomenal and helped out nhs and our communities of vulnerable people survive covid periods. I am surprised some PPs are not recognising this. Bc I don't know any nurses hospital doctors community multi agency trans care home sim carers and social workers that haven't worked ridiculous unpaid extra hours or just simply surviving the huge volume of work we are all doing to keep people safe and out of hospitals.

Step up? So give up our jobs and lose our house as we can no longer pay the mortgage?
Generally people needing care have adult children who are still working full-time.

And home caters. It trans carers ! Sorry! Mistype

Step up beds is what they call hospital prevtyon MDT covered beds in local care homes often block booked

It's not a colloquial phrase! It's not a colloquial phrase how you interpreted it! Lol though

She was referring to a post saying relatives should step up.

Lol yourself

Step up step down/discharge to assess are generally reserved for patients who have capacity or have awi and poa in place. I think the people without capacity and any powers are the ones we need to look at, guardianship takes forever. There is no alternative but to leave them in acute hospital beds.

Sorry I am tired , king day that started at 5.30 am, typing fast and have a naughty phone that has attitude and auto incorrects just as I hit post!

I've posted a bit lately as Some PPs gave birth idea his hard your BHS workers and social care professionals and all those related professionals together in teams are still working. Covid isn't over for us, it's post covid and will be years before our work returns to normal levels. I wish had my 2019 caseload. I wish my colleagues in all the providers and therapy /NHS MDTs had the same level of work back then.

But there were huge investments and continue to be huge work to prevent delayed discharges and Infact is better now despite phenomenal numbers of admissions than it ever was. It's something that invested in heavily. To save lives

the government need to resolve the social care recruitment and retention crisis. That means properly financing individual care plans to ensure better staff hourly pay. Much more preferable to chaotic agency plugging gaps.

Guardianship, DoLs, MCA ,court of protection all add to inpatient stay and are complex with long processes

@Kiwiflower what incentive is there to do well or buy then if all your money goes ? Yet someone who hasn't gets it all paid for and what about when the money runs out as it does quite quicky for many
A lot already pay anyway

This. I thought TM should have stuck to her guns on the policy rather than U-turning when it ran into opposition. Unpalatable truth that needs to be acknowledged!

There should be adverts on TV and social media about living wills and advanced directives. Who cares if it's morbid. Illness, decline and death are a taboo in this country but it happens to us all.

@Icantthinkwhat what so you think eastern europeans should get paid less ? If they live here they have the same bills as everyone else you know?
Labour shortage is another matter but I really find it strange people think its ok to pay people frOm other countries less

@motherofthelittlescreamingone yes the policy with the cap on it made sense but I bet loads of here who are complaining were up in arms about it

Eastern European or any immigrants can't be forced to work in care. Many staff from abroad leave and get other jobs.