14 Jan 2015

Patient log jam in hospital? Send for the Red Cross

It is only 11 0’clock in the morning – mid week –  and there are already  two patients waiting on trolleys in the corridor at the Chesterfield Royal Infirmary.  The bays in the emergency department are  full. Like other hospitals across the country it has been a tough winter here.  More patients than ever have been attending A&E.

And like other hospitals ,  part of the problem has been a log jam caused by patients stuck in beds when they really are well enough to be discharged.

So the Royal has turned to the outside for help.  The British Red Cross.  They have been brought in to help with what is rather pejoratively called bed blocking.

Funded by the local clinical commissioning group, social services and the Cabinet Office, Red Cross staff and volunteers are helping take up to a dozen patients home every week.  They act as a sort of conduit between the ward and the home.  Indeed, the scheme is called Home from Hospital. They are not replacing social services.  Yet they are more than just tea and sympathy.14_redcross_w

Andrew Mullan, service manager for the Red Cross in Derbyshire, explained to us that it was low level support.  They go into the patient’s home and put the lights and heating on, of course make them a cup of tea, ensure they have their medication and some food.

Maybe they will do the shopping.  They will certainly stop and chat.  “Sometimes the patients are too scared to go home,” Mr Mullan said.  “They have been in hospital where they are safe and warm and have attention paid to them and then they face going back to a cold, dark house with no company.”

The patients they help with are not those who need high level support.  That still needs social care of some sort.  But it has become apparent this winter that the cuts to social services has had a major impact on hospitals.

In the health select committee today the president of the College of Emergency Medicine, Clifford Mann, said the recent A&E surge could fill another nine emergency departments. But he also said that 20,382 bed days were lost in December because of the need to find nursing homes or other suitable places in the community.

Yesterday, the head of the association of charity leaders – Acevo –  met senior officials at the Cabinet Office and Department of Health to discuss using the voluntary sector to help with winter pressures. And tomorrow charities will meet in London to draw up proposals for how this might happen.

Which in many ways puts the British Red Cross ahead of the game.

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5 reader comments

  1. Paul russell says:

    This may not be great television but I would welcome an analysis of the sources of the surge in people appearing at A&E. Are we falling over or having heart attacks more than last year? Are GP services contracting leaving people with nowhere else to go, are people misusing the services of A&E turning up with non-serious conditions. On the supply side it seems to be limited available beds due to bed-blocking caused by inadequate support in the community. I would welcome a discussion of the sensitivity of bed numbers to these issues. Clearly the health service does not run with lots of spare capacity so relatively small changes in the balance of supply and demand can have newsworthy consequences.

    One final point, the arrival of the Red Cross is, intuitively, going to make next to no difference. Or is it. Again, what is the size of the bed blocking population and what proportion can be moved by the Red Cross’ people?

    Hard to do in 90s but it is the sort of analysis that would be informative.

  2. Karen Weaver says:

    The British Red Cross is doing vital work here but please note there are many many local charities also involved in providing exactly these sort of services across the country. They manage with tiny amounts of funding working with volunteers supported by locally based small teams of paid staff, building excellent community links which give them the ability to mobilise community action.

    When that meeting takes place in London tomorrow I really hope they don’t talk about how they can “use” the voluntary sector and that is just a slip of the reporter’s pen. Voluntary organisations are not there to be used by government or the NHS, although that is how it often feels these days down here at the sharp end of “low level prevention”. Voluntary organisations are entitled to have their purpose, values and ways of working respected and to expect partnership and collaboration to be the name of the game if this toughest of challenges is to be met.

  3. Angela Sullivan says:

    If there is an emergency of course the Red Cross will help. That is what its volunteers are there to do. That is obviously better than leaving sick people in corridors waiting for beds.
    What is worrying and wrong is that this is not happening in response to an emergency. It is happening in response to cost-cutting. The net effect of using volunteers routinely will be to replace paid workers (home carers, ambulance drivers and sometimes clinical staff) with unpaid ones. The effect on the economy of fewer people In work, fewer taxes collected, nobody with money to spend, is a downward spiral in which businesses cannot expand, productivity collapses and the worsened state of the economy will precipitate more cost cutting. (The government believes this will solve our economic problems, economists are increasing saying that austerity has been taken too far and is worsening the situation.)

    There is also the point that although Red Cross volunteers are fully trained as First Aiders, there is a risk that they will not have adequate training or experience for the roles they are taking on. On balance it is probably better to have an inadequately trained volunteer than no-one at all, but using Red Cross volunteers as a long-term solution to NHS problems caused by mismanagement, understaffing, and low pay is neither right nor good for patients. There is not an inexhaustible supply of volunteers.

  4. H Statton says:

    It is not an uncommon scene to witness the frequent comings and goings of medically trained military staff wandering around, specifically though A&E to sort out the triage system, and designate who could go home and who can stay on Acute Admissions Unit (AAU) i.e. 24 hours surveillance to see how their symptoms develop.

    If a patient’s symptoms deteriorate further they are moved upstairs to one of the appropriate wards, if not that are sent home as there are no beds available. The only other option is life on a trolley for an inordinate amount of time. Thus heralds the possibility of an elderly, frail patient becoming overlook as they are not a priority; sadly this may even result in their death.

    There is constant influx of medical attention seeking patients. The complaints vary from the weird to the wonderland to the alcoholic misdemeanours incurred on Friday and Saturday party nights, broken arms from slipping on the winter ice, chest pain……the list is endless.

    Worst case scenario: a patient is brought in unconscious therefore requires immediate attention, so they are moved straight into Re-sus (Resuscitation), the obvious reason being there are few signs of life and put simply they need all the help available else they might die.

    Our NHS seems to be recruiting different external ‘bodies’ to try and keep the health service healthy. But as things are, this cannot go on for ever.

    People across the country really need to take a stand. I am not talking of the staffs who are working all hours, to try and keep the good ship NHS afloat. As a collective, we in the UK should share responsibility. The NHS is there for us, and we should be there for it.

  5. H Statton says:

    Midlands Air Ambulance Charity

    The Midlands Air Ambulance Charity (registered charity number1143118 [formerly 1001064]

    Their Motto: “Saving Lives by Saving Time”

    The geographical areas they cover are:
    Gloucester * Herefordshire * Shropshire * Staffordshire *West Midlands * Worcestershire

    If you wish to donate some money the number is 0844 567 0844
    There have weekly prize draws.

    Twitter: MAA_Charity
    Facebook: Midlands Air Ambulance

    online: http://www.midlandsairambulance.com

    They rely rather too heavily on the struggling contributions of ordinary people.

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