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?

Do you?

doubt it unless you’re a top rate taxpayer

iwasabedblocker

exactly what happened to two people I know. Absolutely horrendous. Not age related - just post surgery problems and mobility issues.

@iwasabedblocker

Why couldn't your adult children come home and help you?

Why could you have hired a commode abd a perching stool?

Or paid for help?

In the short term we need more domiciliary carers, and better contract with care homes for short term rehab places.

Longer term we need step down units (like we used to have) run by nurses with care assistants.

Finally we need a culture of preparing ourselves this includes having more single storey housing to buy or rent and incentives to move (waiving stamp duty for instance) before health deteriorates. None of us know when we will have care needs but once we are over 70, if we take our time to downsize it saves a lot of issues later - much easier to cope if everything is on one floor!

"Bed blocker" is a horrible phrase

If someone cant leave hospital because there is no care package in place, that's not the patients fault

Properly funded social care. This means investing in the workforce. There are not enough care workers or specialist settings for those who need nursing and dementia care. People need better home packages so they can be looked after at home too.

Local authority budgets got absolutely decimated in the last round of austerity cuts when other departments like NHS had their funding protected. This is the logical consequence of that. The government could put billions and billions more into the NHS but if it’s while continuing to underfund local government, the social care system will continue to be a total mess and the hospitals full of patients who can’t be discharged.

I'm waiting for this govenment to suggest convalescent homes in Rwanda. You can come back when you can pay tax.

These are exactly the attitudes we need to reframe.

These are not problems that acute hospitals should be expected solve.

But somehow we've gotten to this point where people think it's reasonable for the nhs to keep you as in pt in an acute hospital ward or make sure absolutely everything is catered for at home

Sounds horrible you have my sympathy. It must be awful to feel so helpless
The issue is more that society doesn’t look after people now. Family, friends, people exist alone without support. You would really hope in extreme circumstances like yous that one of your family would have stepped it up and helped you.

A trust near me took over a care home and uses that as a convalescence home to keep beds free at the hospital. I think it's a brilliant idea and wonder why more trusts aren't doing it.

How? There are no ‘housewives’ who can pop in on elderly or infirm relatives of a morning. We’re all at work.

We pay low tax compared to many European countries. We just have to suck it up.

What other option is there?

Tertiary care hospitals. The idea to close them has proven to be an extremely bad one.

Personallly, Ithink we need investment into community healthcare, so we can stop people ending up in hospital in the first place.. identify the risks, put support in before people even get to hospital.

Part of the issue is that many people don't think they need help until a crisis happens, so some of it is changing the public perception of community based health provision as preventing hospital admission. So when you start to struggle, accept help rather than getting to crisis point and ending up in hospital.

Invest in falls prevention, invest in community teams who can provide intensive support (over 24 hrs) when someone is unwell. Have a social care system where people can call at 3 am because they need help / they're scared because they are alone.

It's fine to say "stop social admissions" but that means we need funding moved from hospitals who get most of the healthcare money, out to the community so there is enough service for people to have to stay at home.

what happened to the residents of the care home?

@Kenmasterspoloneck I'm not sure it's fair to criticise family for not helping, in today's world

Having centrally funded care homes, not private businesses

This. Care of the elderly needs to become a branch of state funded welfare state. The private sector never provides enough capacity of anything it provides (housing.... transport... childcare....care homes) without state intervention, because shortages of capacity keep prices & profit margins high. Its not rocket science.

The actual care doesn't even have to be fully funded (many old people are in a position to contribute) the state just needs to intervene to ensure sufficient capacity.

I was the only patient in a four bedded bay recently not there because of social issues. Two of the three very elderly frail women were absolutely insistent on going home as they 'could manage'. They could barely get across the ward unaided!
Repeat falls and admissions and bed blocking waiting to happen.
PIL failed to plan for old age and insisted in staying in a three bed house with stairs and no downstairs loo. One nasty fall left MIL a bed blocker for a while. Pots of money. Won't spend it, wouldn't plan. Repeat x 10000.

Topgub Today 19:25
@StoneofDestiny

People want to be kept alive at all cost.

They want every effort made even when there is no quality of life or even chance of survival.

They think the nhs should fix every problem. Right now. For free

Not true at all.
People don't want to be neglected and ignored in the greatest time of need. Their families and friends don't want that for them either. We all need to imagine it is ourselves being referred to as a 'bed blocker'!

People cannot be discharged home following major surgery if they cannot feed themselves, get to the toilet, shop for food, or even reach a phone to summon help. I have nursed a chronically ill young family member at home until they recovered and returned to work to contribute to society. God help them if they had no family, were homeless or simply estranged from sources of help.

I know of an elderly person who lives miles from family who cannot do anything for themselves at the moment following major surgery - they are getting as much help as they can bought in using their savings - and when that runs out............what do you suggest? They kill themselves or we kill them?

We need to keep compassion in our policies, in our government and in our society.