My friend is stuck in hospital because there are not enough staff to process his discharge

[Jacaranda75]

My friend has been in a London hospital for a couple of weeks now (not Covid). He has been well enough to go home for a few days, but the hospital are struggling as so many staff are off with Covid or isolating after becoming close contacts. They just don’t have enough medical staff on duty to cope with even basic procedures such as my friend’s discharge. So he’s stuck there. He’s fine, that’s not really the point.

Things are really bad at the moment. Especially in London. The NHS is on its knees. People saying it’s ‘just a mild illness’ need to think about the impact that it is having.

Too many middle managers, that’s the true problem of the NHS

[quote Jacaranda75]@rrhuth exactly. He should be at home, but they keep telling him they don't have anybody available to process his discharge. He is registered disabled and already on a lot of medication, so I appreciate it might be quite complicated, but nonetheless it is concerning.

And I mean absolutely no criticism of the NHS. Having lived overseas in countries with no universal healthcare, I am extremely grateful for the NHS.[/quote]

It's not that there is no-one to 'process his discharge' though. That makes it sounds the ward staff can't be arsed ti discharge him.

In the contrary with the current shortage of beds, they will be being pushed very hard to discharge whoever they can as quickly as they can.

You said he needs a 'care plan' by which required an assessment and probably a multi-disciplinary team (MDT) meeting to agree his care needs and then the care package to be put in place with the relevant services.

That's going to take time to achieve and will be further delayed because of Xmas and New Year not to mention the staff shortages because of Brexit and the pandemic.

EatSleepRantRepeat what would be the point of the government limiting women to 2 children when on average in the UK women have 1.65 children? China have already tried to reverse this policy. Hospitals are full of the elderly not children.

NHS was utterly broken before covid; nurses underpaid, treatment is bare minimum, no one cares; left hand never knows what the right hand is doing. This is from firsthand experience.
Your friends needs an advocate to help press for a registrat to sign release papers and physio/ governing departmet for care to organise post discharge care & transport.
Do this now or he will be there another 2 wks or until someone needs his bed more.
Overcrowding is based on nhs incompetency and needless paperwork.

Winter is always bad. Covid has hit the care sector which directly impacts on the hospitals. Very high covid absence across all grades. We (NHS staff) still have to isolate for 10 days if we have a household contact. Lots of junior doctors and nurses live in house shares. The absence rate is abysmal. Add in annual leave. Multiply by all sectors of public/social care.

We take it day by day. Nothing else you can do

@KinN thank you for sharing. And thank you for the work you do, which I know is very stressful.

Massive drip feed there.

You said, he was fine.

OP said he was fine to go home but there’s not enough staff for him to leave - literally the entire point of her thread.

My experience pre-covid was that this is very typical- you often need 5 or 6 professionals involved in discharge if there are complex needs (physio, care package organizing, consultant, specialist nurses say if diabetic) and til they've all been and given their two-pennoth, it won't happen, and then you have to get carers/care package in place at home, then you have to get meds. Many times I have run and got the meds myself from the pharmacy. If you are waiting for an ambulance to take you home, say an old person without transport, then add another two days on the top of that.

It's a nightmare and not solely to do with Covid though I'm sure staff shortages are making it even worse.

The system is absolutely broken and I hate to think of depending on the NHS, the people inside it, nurses, physios etc are lovely, but the system is just not streamlined and not efficient (e.g. waiting on very complex prescriptions from the hospital for hours, then only given one week, then the whole prescription has to be transferred to the GP and often it isn't done correctly). Just awful systems and seemingly no money or will to make it more efficient.

Some of this is caused by people living longer now than fifty years ago too

Some people are living longer now, and again this rise in the age of average life expectancy is no suprise, it has been gradually creeping up for the last 50yrs, I think from memory it has only gone up by about 10 years in the last 50. Plenty of time to notice a trend and act on it ?

@Wrongkindofovercoat

Some of this is caused by people living longer now than fifty years ago too

Some people are living longer now, and again this rise in the age of average life expectancy is no suprise, it has been gradually creeping up for the last 50yrs, I think from memory it has only gone up by about 10 years in the last 50. Plenty of time to notice a trend and act on it ?

What do you mean by 'notice a trend and act on it'?

LMAO the NHS isn't full of immigrants.

It's full of elderly people with complex health needs because we've got really good at prolonging life at all costs, but are really shite at providing social care.

The NHS is staffed by immigrants though. Thank god.

Absolutely 👏👏

I think it must vary a lot between areas. My mother was rushed in on Christmas Eve. The paramedics were there within 15 mins .

She was in hospital for 6 days.

She is now out but on palliative care .

Now I am not a complainer and I understand she does not have long to live but there were staff sitting around and chatting and laughing when she had no water or care and no buzzer despite her choking on her own Flem. They also dumped food down that was totally unsuitable for her needs .

A and E when she went in was not busy Or over crowded.

I was so pleased to get her out tbh.

It seems like blaming covid is now the new go to for everything. I had a bad fall 3 years ago and shattered my shoulder into a dozen pieces, my arm bone was detached from the shoulder. I was told to try and get myself to hospital as there were no ambulances. A few years before that I waited two days to get discharged out of hospital because it was a bank holiday weekend. These things have been a problem in the NHS and ambulance service for years unfortunately. You just have to trust that what needs to be done will get done eventually.

We pay for the nhs . We have to make sure the money is spent well and pay more if necessary.

This is not all down to government.

@NoNameHere12

Too many middle managers, that’s the true problem of the NHS

Go back and read the post one or two above you from a middle manager.

That’s what they actually do. Not sit on their arses drinking tea as the daily Mail Wants you to believe. Hospitals need a team to function. Ours would have been on its arse long ago without the long hours our managers put in. Especially this last 20 months.

Its a knee jerk response that is entirely ignorant to the reality.

@Knickerthief1

It seems like blaming covid is now the new go to for everything. I had a bad fall 3 years ago and shattered my shoulder into a dozen pieces, my arm bone was detached from the shoulder. I was told to try and get myself to hospital as there were no ambulances. A few years before that I waited two days to get discharged out of hospital because it was a bank holiday weekend. These things have been a problem in the NHS and ambulance service for years unfortunately. You just have to trust that what needs to be done will get done eventually.

I agree.

I had area baby years ago and there were no intensive care cots and the nhs was on its knees due to a serious flu outbreak .

I don’t understand how people think we can have an army of trained staff on standby for a pandemic.

He is registered disabled

@Jacaranda75

Registered with who?

That should read prem baby

@KinN

I work as a senior manager in the NHS, I’ve literally been home an hour. I was the rota’d bed rep for our division today. Which generally means sorting out delays, long length of stays, shuffling patients around and maintaining flow through the front door.

Here are some of the reasons patients will be sleeping in my hospital tonight instead of their own homes

• Numerous patients medically fit but awaiting care packages. Severe shortages of carers means they stay with us until care can be put in place

• Equipment delays. Patient ready to go but now in a wheelchair. Has to wait for equipment to be delivered and installed at his home before he can go

• Patient refused diagnostic MRI which they need before they can be safely discharged. Would like it tomorrow instead. Refused to listen to reason and unable to force a discharge without it. Patient happy to mobilise for a cigarette every 30 mins

• Patients family refused the care home allocated. Patient now awaiting another home

• Patient caught covid whilst waiting for a care home. Care home now won’t take.

• Patient transport not available to take patient home until tomorrow

• Patient not registered at GP surgery. Needs district nurses. Nurses won’t come unless registered at GP. GP won’t take as full, now waiting CCG to allocate GP

This is just a selection of what we have dealt with everyday.

Thank you for that post. People fire off posts on which they know next to nothing sometimes. Makes some of mumsnet tedious reading at times. So I dont.

Thank you @Tiredalwaystired

I was going to ignore that post, it’s just a sound bite people say without really knowing what they are on about.

To that poster, my 5 year old was in childcare today from 7:30-18:00. She was then picked up by a friend who kept her until 8:30pm for me.

Today I’ve assisted in the discharge of numerous patients, bought lunch for a doctor who hadn’t stopped working for 13 hours, taken numerous numerous phone calls, emails, questions and problems. Sat with a family who wanted answers about their fathers death and god knows what else I’ve already forgotten.

I’ve just fed my daughter; will put her to bed and then I’ll carry on answering emails and trying to sort some kind of safe doctors rota out for the next few days to keep our patients safe.

With the greatest respect; you have no idea what middle managers do or their value.

Yes I get sick of the narrative that goes:

“You nurses don’t get paid enough”

Nurse gets promoted to a position that supports nursing team and gets them more pay

“You’re a waste of space! You don’t deserve a job! Leave immediately! And they can just redeploy the work you do to …uh…the nurses! “

What do you mean by 'notice a trend and act on it'?

Not as scary as it sounds @rrhuth , maybe someone should have noticed an upwards trachejtory 40 years ago and planned services accordingly ?

Or picked up on it 20 or 30 yrs ago given it has been such a steady increase over a prolonged period of time ?

This happened to me in summer 2010 when I had my first DC. Maternity ward so short staffed that there was no one to discharge anybody. The woman opposite had had a Caesarian and they had to test her urine before discharging her. Pots and pots of it were lined up by her bed as no one could deal with it. The problems with the NHS have been going on for a very very long time. Covid has made it worse but it wasn’t great before. Pumping money into it won’t change it. There needs to be a massive restructure but no one has got the bottle to do it.

It’s the ridiculous self isolation rules which are fuelling this. We have 5 members of staff off in a small business. None of them are ill. All have had negative LFTs but they now have to wait 10 full days to return to work.