HCP’s What’s it like in hospitals at the moment?

[Speckledhem]

Just ‘normal’ busy / stressful for this time of year or do you feel Covid is still putting increasing pressure on staff and services?

I'm a paramedic, on my last shift we had two 3.5 hour waits outside a&e before we could offload our patient. This is, surprisingly, not bad!!

There’s just no wiggle room, hence 5 names for a crisis in the NHS and a million different colour coded alerts. How many ways can you say it’s bAd

Not ideal I agree(I now see all this face to face) but they are still dealing with it surely and not sending to ED. A phone consultation still takes the same amount of time and we still have to have the 2m distance rule. Pre covid the government were encouraging GPs to do more remote access and more telephone appointments as it was easier for the patient. Now we are told to see them all..I'm seeing loads but some stuff can be done by phone

Oh and the patient who called with her worsening cough and chest pains last week was incredulous that I had the audacity to ask her to come in. Mainly because she was at the other side of the country!!! Or the patients who insist on a same day appointment then say they can't come in when you ask them too. Or insist on a same day appointment and you decide on a course of treatment and investigation and they don't bother coming to collect the treatment or hand in the samples we have asked for. really!! These people waste appointments and there are too many people for the appointments that are available.

My last reply was to @iluvfriends

Agree that GPs opening up would help massively. Literally had my son at A&E today for a GP job. Very frustrating

From the other side as a GP, we are working at beyond safe capacity. Our clinicians are full every day with a mix of phone and F2F appointments, but we still got loads of people calling for on the day ‘emergencies’, some of which are genuine and we squeeze in to our red hub or with duty doctor, as well as being some of the stuff which shouldn’t be making it to clinicians at all, such as ear ache for 2 hours and nappy rash for 1 day (which hasn’t improved since the last consult 24hrs ago).

The hospitals are busy too, some related to covid and staff sickness, as well as some misusing A&E in the same way they misuse primary care.

Absolutely hideous. I am leaving after 20 years. Sad.

I’m a GP so don’t work in a hospital but I’m dreading this winter. Yesterday saw a v.sick, frail patient on a home visit. Referred to hospital and phoned for urgent ambulance (spent 20 minutes waiting for them to answer the call) Based on symptoms and obs that patient should have been in hospital in an hour. It took 16 hours for the ambulance to arrive!
I’m not blaming anyone, the system is swamped but it really feels like 3rd world medicine at the moment.

I work in a hospital - our Covid numbers are reasonably steady but taking up beds and ITU space that we have never had as always running at near 100% capacity.
However the biggest problem, which if we could solve would mitigate the Covid problem (patients are generally much less sick than the previous wave) is social care. Approximately a third of our patients on the wards are not in need of hospital care, and half of those are ready to leave right now if appropriate care/placement was available. But it is not. Add to that the fact that public health won't allow care homes to accept their own residents back if there has been even one patient or staff member positive in that home for 2 weeks and we have so many patients languishing in an acute hospital bed because they can't go home.

I am in the SE huge numbers of mental health patients. Covid wards still have space but we were hit very badly in the second wave.

It's not because they are jam packed, they just aren't seeing anyone f2f

They see F2F where clinically necessary in our surgery. Many things can be dealt with fine over the phone/video consultation or with photos sent in. Our GP’s are still doing home visits to housebound patients and have been all along.
They are jam packed, some of the things the GP’s & nurses have on their list could be dealt with by people speaking to the pharmacist instead of taking an unnecessary appointment.

So the Nightingale hospitals were worth the money then. 🙄

@Invasionofthegutsnatchers

So the Nightingale hospitals were worth the money then. 🙄

They were a government showpiece. They would of never have functioned fully as no staff. There’s no staff in hospital so where do the extra staff come from? Weren’t equipped enough for either very sick patients or otherwise. A bed is just a bed: a patient often needs much more than just a bed. They may need human care, radiology, pathology, food, bathroom facilities, physios/OTs.

I wonder if quite a lot of extra a&e pressure is caused by people not being able to see their GP. I've been to a&e myself in the last year when the GP wouldn't see my baby in person - and it turned out that he did need to be seen and had been misdiagnosed by the GP over the phone though the GP could probably have dealt with it if she had seen him. I felt bad about using A&E for that purpose but didn't feel there was much alternative. I have heard the same from quite a few parents of young children where they just don't trust a phone diagnosis of baby with a rash etc.

My DD works on wards in a support role. Her hospital doesn't have an A&E, it's planned procedures and Cancer etc clinics. They take the overspill from the two large A&E hospitals and have had to cut down on planned surgery to accommodate them and those who have Covid. They have had more end of life care patients than usual and are short staffed across the board. They are seeing shocking neglect of the patients from the bigger hospitals but it's because of a lack of staff and visitors not being allowed in, who would normally help with care, especially taking nutrition.

I think it's pretty bad at the moment. I work in paediatric oncology and we're starting to see more and more of our children have covid and they're very unwell with it. We've had to split our unit into covid and not covid with staff not going across the 2 sides to try and stop the spread.

I feel for our hcas though tbh. The new 'pay increase' took their standard hourly rate to £9.49 and they work so hard and are so good at their jobs. Usual salary for a hca is about £18500 and they do so much care. I couldn't do my job without them and they're all leaving in droves because they can work in Tesco or aldi for more. Those are the bands that need a decent increase in pay in my opinion.

Hospital is rammed and we're short staffed. Lack of social care means the system is silting up. Also both isolation is so long plus the illnesses are worse so staff are off for longer.

Gp though - amazing. Ds had tonsillitis and was quite ill last week. Treatment was sorted in a 10 minute phone call while I was at work, I didn't have to have a morning off or drag him out to the surgery.

Like the worst part of winter...in October. A perfect shit storm of many things really. Staffing down to the bones, services stretched to breaking point catching up with postponed surgeries etc, lots of very poorly people presenting with things that probably could have been avoided had annual in person routine check ups and blood tests etc been done over the past year and a half, covid still about which is obviously a huge risk to a lot of the vulnerable patients so mitigations and testing still is being done rigorously which takes space and resource, lack of social care workers and people to facilitate discharging people to somewhere safe so they remain in beds, some misuse as always, increase in MH presentations desperate for help that can't be accessed, on the plus side not seen much flu yet.

The hospitals might not be as bad if GP practices & dentists got their act together & started seeing patients again. My mum had her Birthday Review appointment yesterday with the GP, she should have had diabetic bloods & asthma review done before the appointment, she has been ringing every day for 2 weeks to remind them but they never arranged them & then when her review appointment happened the GP said it was a waste of time because the bloods & asthma scores hadn't been done. I'm in desperate need of dental treatment, I've had a couple of abcesses & lost two teeth during the pandemic. I also need some crowns & fillings, my dentist hadn't sent for me for a check up for two years before the pandemic, my lovely dentist retired & the new owner seemed to be running the practice down before Covid. I've had to argue this week to get an appointment even though I am in pain & can't get one until December. It's no wonder people with severe dental pain turn up at A & E. If GP's & dentists got the basics right then maybe there would be less strain on hospitals.

The nhs agenda is to move patients out of secondary care to primary care for things like oncology treatment - care nearer to home. I can’t see how this is feasible when GPs are barely open and are referring patients to A&E for coughs and colds. Where will the staff come from to support all this if we can’t even open up primary care for routine appointments? There will be a massive campaign in 22 to use pharmacy more for routine queries but pharmacies still don’t open later than 5 in my area. There needs to be a huge change in mindset to access from the NHS. And this is without COVID putting additional strain on resources.

I was just wondering the same question. Would love to hear from people actually working in hospitals or within NHS. There are so many conflicting reports it is difficult to know what to believe.

I haven't seen a doctor in over 6 months (very fortunate) and have no visibility into frontline healthcare so it can be quite easy to think - oh life continues as normal what is the big fuss. I wonder if a lot of people just have no idea because they don't see it.

To me this is the most confusing time of this pandemic, should we be worried? Is really so hard to tell anymore there is so much conflicting information around.

In defence of GPs ours is treating more people than before as many phone calls are quicker than the walk from reception to the dr! Anyone who needs face to faceis being seen. They’ve stats out to show it but people aren’t even phoning up they just assume because the news says they can’t see anyone then there’s no point.
The GP surgery is also running Covid and flu clinics at the weekend with their staff all as volunteers.
I was in another GP surgery this week with work and it was full of people waiting to be seen.
Biggest problem seems to be staff shortages and burn out.

Friend working in local hospital said it’s tipped in last few weeks and wards are closing. Husband works with discharged patients and he’s seeing a massive increase of people going to care homes or home with support so they’re obviously trying to clear space.

@10Cheethahcubs

I was just wondering the same question. Would love to hear from people actually working in hospitals or within NHS. There are so many conflicting reports it is difficult to know what to believe.

I haven't seen a doctor in over 6 months (very fortunate) and have no visibility into frontline healthcare so it can be quite easy to think - oh life continues as normal what is the big fuss. I wonder if a lot of people just have no idea because they don't see it.

To me this is the most confusing time of this pandemic, should we be worried? Is really so hard to tell anymore there is so much conflicting information around.

To be honest I think this is the case most winters, many people (thankfully, ignorance is bliss) don't have a clue how close hospitals are to breaking point! Just like anytime if people just use services when they need them there's nothing to be gained by worrying.

As above. Our department is massively understaffed due to sickness, people going off with stress mostly, yet management insist on running at 100%, causing more staff to burn out and go off sick, on repeat.
I consider it a good day if I haven't cried by the time I get to the car park at the end of the day. Haven't done that for about 4 weeks

www.bbc.co.uk/news/live/uk-58992761

The government have FINALLY admitted we are under huge pressure, but then have gone on to underpin it with a HUGE lie that it's sustainable.

I've stated this in another thread but this is NOT sustainable. The wards are over capacity with no where else to place the patients. Our Continuity beds are overflowing. Our trust are kicking people out, regardless of the consequences, regardless of where they are going once out of hospital.

Once they are out of our hospital they aren't our problem anymore and it sucks.