The UK’s National Health Service (NHS) is currently enmeshed in a somewhat baffling bed blocking crisis by medically fit patients. In this article, we will explore the genesis of the crisis and the actions in place to alleviate the situation.
The Bed Blocking Crisis
About one in three hospital beds in the UK are occupied by patients deemed healthy and ready to be discharged. According to data analysis from Guardian, an average of 13600 beds across the NHS in England, houses patients whose doctors have medically cleared them to go home or receive home service care.
However, a shortage of staff in the social care realm permits the occupancy of beds by medically fit patients for weeks upon weeks. This has also contributed to fatal ambulance delays and the crisis appears to loom larger by the day.
An investigation by the HSJ unravelled a series of alarming waits. A medically fit patient in North Bristol Trust was stuck in bed for over 9 months, waiting to be discharged. Another patient in the same hospital waited 8 months.
The story isn’t any different at Gloucestershire Hospital Foundation Trust and North Cumbria Integrated Care Foundation Trust, where 6 months plus waits have been recorded.
What Could be the Problem?
Discharging patients after a stint with illness should be one of the most gratifying things in the NHS, unfortunately, nurses and other healthcare specialists are forced to deliver bad news to patients, who are anxious about leaving the hospital. This is especially distressing for elderly patients who crave social care.
After being declared fit and healthy, it can take up to several days or in worst-case scenarios, months of waiting in the hospital before they are finally discharged (due to social care shortage).
By Sunday, the 15th of January, the statistics showed an estimated 14,036 beds were occupied by medically fit patients who are stuck in the hospital and awaiting discharge. Expectedly, the discharge backlogs have affected paramedic services, A and E medical personnel and other front-line staff, where terrible waiting times have become the bane of their existence.
The Social Care Sector Bears the Brunt of the Blame
Annual figures released in March showed that there are about 165000 vacancies across adult social care in England. Scotland and Wales also confront the same recruiting challenge.
The shortage in the workforce is a direct influence of low wages. Thus, the social care sector finds it increasingly difficult to recruit workers while existing workers hand in their resignation letters.
About half of the social care workers in the UK receive average earnings of £9.50 per hour which is somewhat on par with the national living wage and lower than the minimum rate earned by workers in the country’s top supermarkets.
Some of these patients need house service care at least three times a day while others must be enrolled in a care home or demand round-the-clock attention. But sadly, even patients with minimal requirements have to contend with frustrating delays.
Besides reaching a “patience” limit, the backlogs can expose the already-treated patients to infections and increase the risk of muscle wastage. Most of these patients are elderly and immunocompromised, which means they are susceptible to hospital-associated infections.
And given the staff shortage in the hospitals, nurses are overwhelmed and spare minimal effort and time to help these patients. They are left to their own devices with no one to help them out of bed or walk them to the toilet.
Soon, they begin developing infections which further delay their long overdue discharge. It is a “vicious cycle”. As a case in point, 566 patients died in Scotland while awaiting discharge in 2019.
But besides the shortage crisis, the UK Daily Telegraph also named “bureaucracy” as one of the culprits.
The Role of Bureaucracy in the Crisis
According to the Daily Telegraph, hospital staff are required to complete 50 steps before discharging a patient. Doctors and healthcare specialists have confirmed that the NHS bureaucracy and extensive form filling is a primary contributor to delayed discharges.
In a survey by CHS healthcare, the majority of hospital and social care workers stated that admin, bureaucracy and mountains of paperwork stretch discharge time. From completing paperwork to approving funding to arranging transportation, the procedure is endless and utterly frustrating.
Conclusively, there is a need for a single, trusted assessment and a readily-available record to counter the problem. A patient’s records should be readily available to all staff involved in the patient’s care to expedite the discharge process and provide necessary social care.
An End in Sight?
The Health Secretary, Steve Barclay has revealed the Government’s plans to ease the bed-blocking crisis by block-booking beds in residential homes, such that 2500 medically-fit patients can be discharged from the hospitals.
He sympathised with the plight and expressed that an immediate action was necessary to counter the challenge, pending long-term sustainable solutions. So to tackle the crisis immediately, the UK Government will block-book thousands of care home beds to free up space in hospitals. The project is estimated to cost £200 million.’
Mr Barclay said that A & E capacity will also be improved by introducing modular units (costing £50 million) to expand the available space.
However, healthcare experts have debated the temporary solution. Stating that workforce shortage is the primary concern and block-booking beds may not curtail the crises.
The Bottom Line
The bed blocking crisis has birthed unimaginable discomfort for patients and staff involved. Hospitals are filled to capacity, thousands are waiting to get admitted while a thousand others can’t wait to leave. Healthcare staff are stressed to capacity, medically-fit patients are developing infections while awaiting discharge and the social care sector suffers workforce shortage.
It is imperative to find a lasting solution to this crisis given the delicate nature of the healthcare sector. Otherwise, a much bigger pandemic may assail the UK and environs. In the meantime, you can hire home service care specialists for your loved ones to counter the current challenge.
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