It is shocking, and it's playing out all over the UK. I'm going to stay off my political soapbox but this is what happens when systematic underfunding and rot sets in.

Awful. I do know of a few children who have had operations cancelled because there have been no beds.

I had mine cancelled three times for the same reason.

No ITU beds.

No room in A&E. 2 symptoms of the same issue: "bed occupancy & throughput"

It is "plumbing" ; flow in vs. flow out.

If there aren't enough ward beds, patients from A&E can't get admitted.

If there aren't enough ward beds patients from HDU/ITU can't be discharged to a ward, and stay on HDU or ITU until a ward bed becomes available, or (rarely, but a shocking indictment of the system) discharged from the hospital after a number of days being on HDU when they could have been in an "ordinary" bed.

Blame the "bed blockers"!. Except, many of them don't want to be there and would prefer to be in a more appropriate care setting : except these can't be found.

Ohh, and check the STP for your area, to see how many beds are being lost in your area.

No doubt you'll be told "the beds we are closing are the wrong type of beds" but even if they aren't ITU, HDU, or "general medical / surgical" beds : won't closing them add to the issue of bed blocking??

It is marvellous if changes will make things more efficient, keep people out of hospital & long term solve all the woes of the NHS. Yet, the efficiency savings will take investment and TIME to be seen.

Defund current services / close beds once the efficiencies are being seen. They aren't a realistic excuse to cut services / beds now.

Ohh, and don't blame the GP's!

TAI's excellent post at the bottom of page 2 of this thread highlights the "plumbing" issue and shows why it isn't the fault of the GPs, (who are already doing more & more work that used to be done in secondary care), either......

It's a mistery to me why they cut NHS funding instead of other areas that are not essential.

They surely have they priority list upside down.

By coincidence we currenty have both our fathers needlessly taking up hospital beds whilst appropriate care packages are put in place so that they can return home. Both have now been in hospital for well over 2 weeks for no medical reason whatsoever, but this is apparently how long it takes to organise these things.

It's a mistery to me why they cut NHS funding instead of other areas that are not essential.

They surely have they priority list upside down.

No matter how much is spent in the NHS, there could always be more spent on it.

That ("well, the money has to come from somewhere, and we could always spend more... and more" ...) and the fact that there will always be examples of waste in the system that can be trumpeted, somehow gets turned into a reason to not spend enough ......

I came across this too, RMW.

My father was very ill in 2015 and just wanted to go home for his final days. It took the best part of a week to organise the care package and a friend who works for the NHS said she thought they would be arguing over who would fund it. My father made it home with less than 24 hours to spare, it was a shame he couldn't have had a bit longer in the home he loved instead of blocking a bed in the hospital.

HB

By coincidence we currenty have both our fathers needlessly taking up hospital beds whilst appropriate care packages are put in place so that they can return home. Both have now been in hospital for well over 2 weeks for no medical reason whatsoever, but this is apparently how long it takes to organise these things.

If kept in long enough, they are at risk of getting a hospital acquired infection, which then needs treatment, and may prevent their discharge.

It can be a self-fulfilling prophesy.

Look at the STP for Cumbria recently highlighted in "i" (what used to be the independent); community hospitals face downgrading / closure. Similarly for Devon.

Of course the staff don't want their jobs gone. Of course the local people oppose their "local unit" being closed. But the opposition should also come from those who won't be directly affected ..... until they can't be discharged from another hospital, who should already be asking "won't this add to 'bed-blocking'? !

I came across this too, RMW.

 

My father was very ill in 2015 and just wanted to go home for his final days. It took the best part of a week to organise the care package and a friend who works for the NHS said she thought they would be arguing over who would fund it. My father made it home with less than 24 hours to spare, it was a shame he couldn't have had a bit longer in the home he loved instead of blocking a bed in the hospital.

 

HB

Sorry to hear this, HB.

Sometimes the issue is funding (and who is paying!), sometimes it is getting all the different parts of the system working together, sometimes it is physical availability of a suitable place ; often it is more than one of these.

"Bed blocker" / "bed blocking" is a term that encapsulates the issue, so is a useful & widely understood term but risks the hint of shame on the "bed blocker".

both recent press coverage and people's personal experiences (like yours with your father) remind us that these unfortunates are the symptom of the system's problem, and would much rather be out of hospital, so while the term is useful for discussion of this important issue I wish there was a better one that didn't make it sound like the patient was at fault.

("Bed 3 in Bay 4 is still blocked, no sign of any movement")

I just haven't found a better alternative that is so widely understood, yet,

Our current situation also highlights some of the issues elsewhere in the system. My mum, who is herself not well, has been back and forth to their GP since before Christmas saying something was very wrong as my Dad had basically stopped eating or drinking amongst other things. It took until 2 weeks ago when he collapsed for her to be taken seriously, but by then of course he needed to go to hospital whereas perhaps if someone had listened earlier, that could have been avoided. After a couple of days treatment he was pretty much ready to be discharged but Social Services are adamant my Mum can't cope on her own so they won't let him be discharged until they've organised home carers to call in at least twice a day. Mum accepts she can't cope on her own for long, but she and my sister were happy to manage for a while between them if that would have got Dad out of hospital quicker, but I suppose if something had gone wrong the hospital and social services were worried that they would have been blamed for discharging him too early.

My father in law also collapsed, but in his case there is no family able to care for him at home (I'm too disabled and my husband works away) so there was no choice but to keep him in hospital. Again, though he lives in supported housing, apparently no one noticed that he'd not been around for a few days - at least 4, possibly more - which makes me wonder what the point of supported housing is and why we're paying for it.

They cannot hold your dad in hospital without his permission: It's not a prison. (They cannot throw you out either, although I have read of instances of elderly, vulnerable patients being discharged in the middle of the night). However, caring for a sick relative must be intense, physically and emotionally and the burden would fall on your mum, who you say is also unwell. You don't want her to end up in hospital too.

The system for (safely) discharging patients really does need to be slicker. The wheels - whether it's the social workers and care packages or medicine dispensing - seem to turn so slowly.

If kept in long enough, they are at risk of getting a hospital acquired infection, which then needs treatment, and may prevent their discharge.

 

 

!

Or kills them as it did my Mother !

the cause of all of the NHS problems is the patients- They keep surviving all of the things that uswed to kill them. Go back a good few years and ambulances went to the scene and scooped up the bodies and delivered them to hospital. Nowadays the ambulance crew usually consisat of a driver that also has technical skills and a paramedic. This allows the ambulance to do a lot of the work that had to be done at a hosptal thus making the "golden Hour" mean something.

Then let u smove on to the hospital. Advances in diagnostic techniques such as CATscans maens that the problem with the patient can be identified much quicler and with a level of precision undreamt of 70 years ago. The we have the initail treatment stages wit things like whole body cooling, brain cooling, heart and other organs taken over my machinry whils the surgeaond get ready to get stuck in.

Also, the drug regimes, surgical techniques, etc all mean that someone who would have been DOA years ago not only survives but has an aecellent chance they dont end up with life changing aftre-effects. This all coats a vast amount of money and then at the end of it you have a population that is aging because they arent killing themselves or being killed by their employer. this means that peopel run out of things to diw suddenly from so we are left with cancers and dementias, which are darwn out, expensive and horrible to watch.

One day we are gooing to have to decide what we want from the NHS, a cure all at any cost or a servcie that has defined limits, as it did in the past. For example, why fertility treatment on the NHS? Do we as a nation want topay a fortune so someone can have a baby when the world is already massively overcrowded. It is not an illness to be infertile, just a circumstance of life. I would also drop all of the anti-smoking legislation regarding advertising of fags and the like. People have know that smoking kills, let them geton with it as cheaply as possibe, the tax revenus will pay for their last 18 weeks on earth and quite a bit left over. also means they dotn get an old age pension so more millions saved. I dont smoke so would encourage anyone not related to me to take it up so I get my pension.

Also agree about the pint on 7 days a week doctors service. My locla GP surgery has staff other than doctors already working the maximum permitted hours (48/wk) so that means to have the GP working an extra hour they have to employ another person full time so how can savings be claimed as a result? The GP's also work close to the 48hr week so again that means another GP is needed and that means more funding, the bit that no-one wanst to admit. Who is going to use this new 24h service? look into any surgery and you will see it full of pensioners, they dont have a problem attending any time you tell them to but will sya when given a date for a blood test "oh I cant make next wednesday because it is my flower arranging group" or some other rubbish excuse. the peopel who would benefit from late or early opening arnet ill that often so it all becomes pointless. Already been shown in a report into the same subject 20 years ago.

An example of waste..

Hubby has had a prostate problem. A couple of weeks ago he makes an emergency appointment with GP - who refers him straight to A&E. Seen immediately, no complaints there. He is catheterised and sent home with insufficient spare bags and advised to make contact with the District Nurse - who lives 70 miles away !!

The saga that followed in attempting to obtain more bags was worthy of a comedy sketch.

Phones DN - told to speak with GP - GP said - not our problem you were seen by A&E - Urology Department said - you have not been referred to us from A&E yet (2 weeks after visit) speak with the District Nurse.

Speak with DN, again, told - you will have to make a 35 mile round trip to the Surgery/ clinic that I service in order to pick up.. one bag !!

Intervention of Grand daughter who is a Practice nurse in London - 180 miles away - has the local hospital make arrangements to send sufficient bags for a further 2 weeks. A detailed list was given to them.

However, when they arrive - there is a selection - mostly the wrong size and overnighters which he doesn't require and only a couple of the day bags which he urgently requires !

Supplier will not accept any unused/unopened products as they have left a sanitised area. He has over 20 night bags - a night stand, tubes, wet and dry wipes - all of which will be required to be 'thrown away'

I wonder how many times this happens and what the cost has been to the NHS ?

One of the projects I worked on before I retired was artificial bone. We made a decent bioglass that could be used in dentistry, basically like a filling that then the body assimilates into the enamel of the tooth. This glass costs about £5 a kilo to make and has a shalf live of around 6 months because it absorbs wather and then changes its characteristics.

The original trails were carried out with samples straigth from our labs but when it was agreed to be put into production the quality control paperwork pushed the price of the glass up to about £200 a gram. The People employed to make the decisions for the NHS are paid £70k a year (I knew them quite well) and although for a new process this is understandable for a bog standard ISO certifiaction it is ridiculous to have people on such a salary checking someone else's tick boxes.

I also know that in some countries where medical equipment was sourced bribery is the norm and although the people I knew were above reproach it does make you wonder what happens to let some businesses have access to the NHS as a market.

Another change that most people wont know about is when I crewed an ambulance for the red cross we used to restock dressings and the like we had used by raiding the A&E cupboards in the hospital we had just wheeled someone into. Nowadays the opposite is just as likely with ambulance crews borrowing stuff from the volunteer ambulances as the hospitals hadnt returned their blankets,gas etc

 

For example, why fertility treatment on the NHS? Do we as a nation want to pay a fortune so someone can have a baby when the world is already massively overcrowded. It is not an illness to be infertile.

I feel very sorry for those women who are unable to have children due to a design fault - however, I do not consider that this should be paid for, even in part, by the NHS.

nhs hospital cuts 'planned' over a '5 year strategy' to save money says the beeb. http://www.bbc.co.uk/news/health-39031546

why?...in a couple of years, if not before, there'll be £50million / week available for the nhs...

I have just been listening to a report on the BBC news - I understand that they want to centralise cancer care in units of excellence. Remove maternity units from pretty much every other hospital and amalgamate them. Spend more money in moving people out into the community for treatment.. eg - some cancer patients can administer their own drugs - some patients can have dialysis in their own homes, etc.. but.. they will then reduce beds in local hospitals ? Surely the idea is to free up those beds that are already full with patients that do not necessarily require a hospital bed ?

If kept in long enough, they are at risk of getting a hospital acquired infection, which then needs treatment, and may prevent their discharge.

It can be a self-fulfilling prophesy.

!

My dad had to have his appendix removed about 4 years ago. After finally getting admitted, (they had to beg for someone to see him - he got taken up on the Tuesday and finally admitted and operated on the following evening) his appendix by this time had burst. He'd picked up an infection or something whilst in there; so had to spend almost a week in hospital.

My dad had to have his appendix removed about 4 years ago. After finally getting admitted, (they had to beg for someone to see him - he got taken up on the Tuesday and finally admitted and operated on the following evening) his appendix by this time had burst. He'd picked up an infection or something whilst in there; so had to spend almost a week in hospital.

The appendix having burst would have been enough to cause infection.

If removed before bursting, any contents "spilt" as it is cut will be spilt outside the body. If already burst, it will have spilt bowel contents inside the body.

Bazza, that sounds awful, I can hardly bear to think about it. My OH nearly died from peritonitis when he was a child following a burst appendix.

I imagine the point of Nystagmite's post is that if their father had been admitted earlier, he would have spent less time in hospital and cost the NHS less, unless I've misunderstood something.

HB

I have just been listening to a report on the BBC news - I understand that they want to centralise cancer care in units of excellence. Remove maternity units from pretty much every other hospital and amalgamate them. Spend more money in moving people out into the community for treatment.. eg - some cancer patients can administer their own drugs - some patients can have dialysis in their own homes, etc.. but.. they will then reduce beds in local hospitals ? Surely the idea is to free up those beds that are already full with patients that do not necessarily require a hospital bed ?

Here is what i think will happen. They will reduce beds in hospitals and tell people that they either carry on recuperating at home or pay for nursing care at their own cost. Particularly for elderly people on modest pensions, they will find it quite expensive paying for respite care home places.

I get the distinct feeling that tne current Tory government have placed a limit on what they are willing to spend on the NHS and if people want more they will have to pay for it. Because it is too difficult politically to apply charges to hospitals and GP services, they will find ways to release people from Hospitals more quickly, putting pressure on families to sort out care arrangements locally. Where people do not have families to sort out care, they will be placed with private care providers where the cost of care is paid by the patient or if they qualify by their local authority.

Bazza, that sounds awful, I can hardly bear to think about it. My OH nearly died from peritonitis when he was a child following a burst appendix.

 

I imagine the point of Nystagmite's post is that if their father had been admitted earlier, he would have spent less time in hospital and cost the NHS less, unless I've misunderstood something.

 

HB

My limited understanding of that particular operation is that it's usually small and doesn't require much time in hospital. Dad was left with rather a large scar and like you said, would have spent less time in hospital in he'd been operated on sooner.