Wednesday, December 9, 2015

Choked

You have to be careful nowadays- the main 2 corners of NHS emotions either centres around doom and gloom  deep from the bowels of Mordor...or happy, shiny positive change things- where unicorns gently glide over sparkly rainbows- and you have to be careful not to be sucked into either of those- as the reality of the NHS continues to be somewhere in between. Mostly average to good care- spattered with examples of excellence and blighted by occasions of poor care- what we learn from either of those-again-is variable at best- but that pretty much in a nutshell is where we are.

 However, all said and done, what I am seeing now is a situation I at least have not witnessed. There are many merits to the discussion about family structures and what support children offer (or don't) to their parents- and perhaps much of that has been masked by the social support provided by the State..but we are now in different times. Hospitals are now having greater number of patients inside hospitals waiting for "something". Bed blockers is a reprehensible term- one to be condemned to the history books- and the dissolution of social care is now having a domino effect on many a services. 

Think of this scenario...hospital beds are choked...greater number of patients are stuck due to no fault of theirs- the 4 hour target creaks and understandably hospital managers are under the kosh to try and resolve this. The irony? No amount of doctor time would help in helping these people go home- all it does is either make the doctor a bit richer or cancel elective work- causing further knock on effects- whether it be simply put financial revenue for the Trust or simply poor care to those for whom THAT elective clinic has been one they have waited for- or is of utmost importance.

Social care is now in crisis- and there needs to be a realization that the NHS needs to focus its attention to have a concentrated effort in raising a collective voice asking "what next"? I do ward rounds on weekends- and bed after bed I walk past- with frustration- unable to contribute much as a clinician...and that number is increasing every single time I go back on the wards. To the powers that be, please do raise the query- either that or we challenge the structure of a society which has devolved the responsibility of their parents to the State. 
I have sympathy for hospitals who are beaten up over a 4 hour target when a significant reason for that isn't due to lack of medical/nursing engagement or simply "process". What does happen as a consequence is those who are in hospitals due to genuine medical reasons are then discharged quicker, a bit more risk taken, a bit more closer to the edge...opening up further gateways to error- ask any GP and they will tell you about the patients being sent home- the risks being taken nowadays

The system is choked- and now the knock on effect is falling on edification  elective work, challenging safety and going to the basic core of keeping patients safe. More doctors and nurses isn't the answer- use that money (if you have it) to buy social care- THAT will keep patients safe- that will help patients- and that,just, may help the 4 hour targets.

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