We're Just Such An Inconvenience To The NHS, Aren't We?

As ambulances queued in front of Royal Berkshire Hospital in Reading last week, corridors full of patients were waiting for a bed on a ward. Emergency department consultant Omar Nafousi was at his wit's end. "We've no space," he told the BBC last week. "This is not what I signed up for when I became a doctor."

Like the appearance of Cheesy Footballs in the supermarkets and Cliff Richard on the sound systems, this is a regular part of winter. 

Currently nearly 4,000 beds in England alone are taken up by patients with flu, Covid and the vomiting bug norovirus, according to NHS England, and the situation is on a similar scale in the rest of the UK. But that is dwarfed by another pressure – the patients who should not be in hospital.

Such as?  

Every day there are more than 13,000 people whose treatment has been completed who are still in hospitals in England, the latest figures from NHS England suggest. Plus there are a further 4,000 around the rest of the UK - which means around one in eight beds are occupied by people who don't necessarily need to be there. Many of these "delayed discharge" patients are older and may be frail and living with multiple health conditions who need support in the community.

This isn't new, is it?  

The issue of delayed discharges is far from new. For years, it has been talked about, if not agonised over, and the NHS started tracking the delays in the early 2010s.

Tracking the delays - not solving them. Doesn't that just sum up the NHS? And now they are thinking the unthinkable.

Yet the problem throws up many deeper questions about the care system, coordination and planning in hospitals - with some doctors even asking whether the NHS is over-treating patients, particularly those at the end of life.

Yes, pay in to the obscene Ponzi scheme that is National Insurance all your working life, only to find some heir to Harold Shipman is going to consider you a burden to the glorious NHS and ship you off to die... 

Some NHS trusts have bought places in care homes to allow them to discharge patients. University Leicester Hospitals NHS Trust has taken this one step further: it has spent £10m buying and renovating a former care home in the city called Preston Lodge, which opened in July and has more than 50 beds.

And they'll tell you it's all for your own good: 

In Price's view, her own profession bears some responsibility, too. She says about a third of people who are admitted for medical reasons are in their last year of life. "We admit them and end up over-treating them with interventions, scans and pills," argues Price, who is president of the Society for Acute Medicine.

She says for many of these patients, palliative care and managing their symptoms, mainly pain, would be preferable: "Their quality of life would be much better and we would avoid a hospital admission."

I don't know why I'm surprised they are admitting it.