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.

@EatSleepRantRepeat

They love blaming the old and obese *@mojoj* , but I don't know a single obese person who doesn't have other chronic healthcare needs / disabilities that have caused that situation. I'm sure our local NHS service would be a lot healthier if they hadn't built multiple-100s of new flats and houses within 3 square miles of my home, with no extra doctors surgeries, hospitals, ambulance stations etc.

I hope people remember this next time people think we shouldn't control immigration, or the usual mumsnet approach of "if you can afford another kid, just do it" - overpopulation is a massive issue for the NHS as well.

The NHS isn't full of immigrants, its full to the brim of old white british people. Any money they have paid in has been spent!! if a woman retired at 60 and they are 95 now they almost spent the same amount of time in work as they have out of it! and they almost have long term conditions which are expensive and time consuming to manage.

The immigrants that are in the NHS are wiping the backsides of the white British patients, and we should be grateful that they are, because there are plenty of people who don't take care of their relatives because its always 'someone else's' responsibility. But they'll be around to collect any inheritance though!!!

@Wrongkindofovercoat

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 ?

We've had Tory governments for the majority of that time. They cut things.

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

How would you restructure it @BunsyGirl ? I hear this a lot, that it doesn't need more money or more resources such as staff and the like, what it needs is another lovely expensive restructure, get all the Trusts to change their names again, fork out a small fortune in new name badges and funky paper work. But if you have a constructive and acheivable plan on how to use the resources available to provide the level of care people need, then several million people employed by the NHS are all ears

@BunsyGirl

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.

Pumping money into it won’t change it.

This is not right.

UK spends way less per person on the NHS than other wealthy countries.

Money definitely would change it.

Same happened to my dh long before Covid. He was better and ready to go home but there wasn’t anybody available to complete his discharge and sort his meds out.
I had stripped his bed to help the ward staff so then ended up having to remake it for him!

NHS has been falling to bits for such a long time I don’t think anything can save it now…

This person isn’t being delayed in their discharge due to their being inadequate NHS staff to prepare the discharge. This is a common issue that happens due to chronic underfunding of social care alongside the inability of health and social care professionals to work together…and I say this as a social care worker. The sectors are not cohesive.
Delayed transfer of care has been happening for years. There are not enough care staff in the community, nursing homes or residential care homes. Society does not place any value on the importance of skilled care workers. This isn’t Covid related. That said, in recent months, there has been an exacerbation of the problem due to; fewer care workers due to Brexit, care staff with covid or isolating due to Covid and finally, the impact of mandatory vaccination.

^^ aarrgh
There not their and probably some other errors.

Unless he can't walk by himself/needs to go home in a bed, he can discharge himself and take a taxi home. After he's been given medication, of course.
The amount of people requesting hospital transport home after simple procedure and staying in hospital for 1-2 days, is astonishing- as I have witnessed, when my brother stayed last week. DBro simply collected his medication and we called a taxi to take us home. Some of the people on his ward were waiting for more than 12h for hospital transport to take them home 15mins away. We are in London.

How would being treated by covid-positive staff help the elderly and vulnerable who need treatment in hospital?

I don't know, I imagine it's already happening. Covid is rife, did you not know?

@rrhuth yes, we do spend less but putting more money in without changing the system won’t get us a French or German level of healthcare, it really won’t. Also, people forget that the US spend a massive amount on healthcare per capita but the overall system is worse than ours with a poorer outcome (lower life expectancy). It’s not just about the money, it’s about how you spend it.

@Wrongkindofovercoat we look at health systems that work and copy those. That’s not the US by the way who spend way more than European countries per capita with a far worse outcome.

[quote BunsyGirl]@rrhuth yes, we do spend less but putting more money in without changing the system won’t get us a French or German level of healthcare, it really won’t. Also, people forget that the US spend a massive amount on healthcare per capita but the overall system is worse than ours with a poorer outcome (lower life expectancy). It’s not just about the money, it’s about how you spend it.[/quote]
You are just guessing. Those who know about healthcare and who are not ideologically opposed to state healthcare say it is about the money.

So in my view, let's invest properly and then review.

From some of the comments on this thread it could be inferred that we spend significantly less than most of the rest of the developed World on healthcare. That’s not true as the chart below shows. I am not saying that extra money shouldn’t be spent on healthcare in the U.K. I’d saying that we need to change the system to change the outcome.
www.statista.com/statistics/268826/health-expenditure-as-gdp-percentage-in-oecd-countries/

@BunsyGirl

You have to invest first. Structural changes in a system with 100k vacancies are going to fail.

it is the lack of carers, to enable a care plan
social care is in dire straits
does he have enough to do while he waits?
can you take him something to take his mind off the situation?

@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.

Wow. This is an eye opener into what you do. It should be pinned every time someone says there are too many chiefs, not enough Indians. And while we are at it, can we please invest and bring back matrons on wards.

Yes, it should be an eye-opener for everyone who doesn't realise what the social care crisis is a reason hospitals are full. Only one of KinN reasons is the hospitals issue - contacting covid whilst in the hospital, and only one is down to the patient - the MRI.

The rest is all about social care.

As said earlier in the thread, if you can't discharge, then you fill up and admissions have to stop too, regardless of the capacity.

they have bought back matrons,
i dont see what good that does personally

[quote BunsyGirl]From some of the comments on this thread it could be inferred that we spend significantly less than most of the rest of the developed World on healthcare. That’s not true as the chart below shows. I am not saying that extra money shouldn’t be spent on healthcare in the U.K. I’d saying that we need to change the system to change the outcome.
www.statista.com/statistics/268826/health-expenditure-as-gdp-percentage-in-oecd-countries/[/quote]
Although when your staff are working with systems that still include fax machines and windows 7 then perhaps that
A) explains some of where the lack of efficiency lies
B) gives a pretty damn comprehensive argument for where some investment should be going.

[quote BunsyGirl]From some of the comments on this thread it could be inferred that we spend significantly less than most of the rest of the developed World on healthcare. That’s not true as the chart below shows. I am not saying that extra money shouldn’t be spent on healthcare in the U.K. I’d saying that we need to change the system to change the outcome.
www.statista.com/statistics/268826/health-expenditure-as-gdp-percentage-in-oecd-countries/[/quote]
Many people in this thread have missed the point. This isn’t an NHS problem, this is a social care problem.

@KinN as a doctor I would just like to say thank you for everything you, and all middle managers everywhere - do.
I have had to email my trust managers this week after testing positive myself. They have been fab, helping me count days for lfts and isoltion when my brain was too scrambled to work (!) and covering my stuff when I couldn't come in, and always with a kind and thoughtful email response, hoping I was feeling better. The managers have so much to deal with at the moment, and do a wonderful job IMO.

@greenweepingwillow, coincidentally I am actually arranging LFTs and PCRs for doctors right now!

Nothing needs to be in place for him to leave.

*Is he waiting on hospital transport? Grab a cab, jump on a bus, arrange a friend to pick him up or walk?

We need to sort these things ourselves to keep the system moving.

You said he is fine

@LostForWords2021*

Have you met and assessed this man yourself then? What a silly and pointless post otherwise.
I'm amazed that so many people really can't see the difference between being fit for discharge (IE suitable transport, medication, follow up care arranged) and walking out of the hospital.

Looking at that statista data, we spend considerably less than the countries which are usually quoted as having better health care than we do.
U.S. 10948
Germany 6518
France 5274
U.K. 4500
I know there are cheaper health systems, but I’ve never heard anyone raving about how wonderful health care is in Slovenia (nothing against Slovenia, I just picked a random cheap country) nor do I think it’s fair to compare our health costs to say those of Japan, where diet and lifestyle are radically different.

@nellodee the statista data was behind a paywall for me.

We have a home in France and I'd be happy to pay more for an equivalent UK system. However, I think it would take more than that for UK and NHS systems to reach comparability.