Hospitals ‘desperate’ to discharge patients warn ambulance delays are ‘life-threatening’

Hospitals “desperately” free beds can be put patients at risk The Independent it was said

NHS trusts Experts warn that they are being forced into “risky behaviour” in an effort to free up hospital beds and emergency rooms.

It comes as new figures show that waits for ambulance crews outside the hospital reached 26 hours in September, with more than 4,000 patients likely to be seriously harmed by the delays.

The documents were leaked independent Hospital chiefs in Cornwall have warned staff that current pressures on the A&E system and ambulance delays have ‘tragically led to deaths’

The Royal Cornwall and Cornwall Partnership Hospitals said in documents that A&E delays and waits in A&E were a “risk to life” and as a result they now plan to start discharging patients to the voluntary sector.

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The paper says: “It is likely that the risk of such support not being appropriate for all individual patient requirements is less than the risk to life currently experienced in the community when there are significant delays in transfer at the hospital front door.”

It comes after the North West Ambulance Service launched an investigation after a patient died while waiting in the back of an ambulance outside an emergency room.

In response to deteriorating A&E and ambulance waits, NHS England has urged trusts to speed up patient discharges, with more than 10,000 patients due to be discharged staying in hospital every day.

Hospitals around the world have started using a model where patients leave emergency rooms every two hours, regardless of the availability of space in emergency rooms.

Concerns have been raised that this model will result in patients being herded into wards or ‘patient dormitories’. which means that people are not being placed in the right type of ward.

Dr Luella Vaughan, a GP in London and senior researcher at the Nuffield Trust, warned that evidence showed that ‘boarding’ patients increased the risk of death by 2-4 per cent.

Talking to The Independent She said national policies encouraging these models were potentially forcing trusts into “risky behaviour”.

She said: “Every year we have a blizzard, oh my god, it’s going to be the worst winter on record, every year NHS England puts out a set of things that hospitals have to do quickly, with no resources and no time. .

She said the policy did not address “underlying structural problems with recruitment and retention and capacity and patterns of care”.

Dr Vaughan added: “At the moment we’re seeing people lying on the pavement for six to eight hours with a makeshift tent for these things and it’s horrible. This needs to be fixed, but excessive care on the ward can result in elderly patients lying in their own urine and faeces and not receiving their medication. without drinking water. They die too. They just don’t die in the public eye.

“Next year will be 10 years since Francis’s report. It showed that neglect of care is due to stretched nursing services, and it is not the nurse’s fault.”

“I’m very worried about what could happen to the forced flow model if the underlying structural problems surrounding the lack of welfare are not fixed.”

The Care Quality Commission warned on Thursday that the “deadlock” in health and social care is putting patients at risk as social care capacity and staffing are unable to meet demands.

Doctors across the county told The Independent Emergency departments are “still overcrowded with many patients ready to be discharged, blocking flow.”

One emergency doctor said: “I’ve never seen anything like it, but it’s not surprising. Everyone feels exhausted and frustrated.”

Another doctor in Newcastle said: “We are desperate for discharges – it is very difficult to get frail elderly people out of hospital at the moment. I think we have around 100 (patients) with delayed transfers.”

“Risk to Life”

The leak of documents in The Independent It revealed that Royal Cornwall Hospital and Cornwall Partnership Hospital told staff in September: “The health and social care system currently has no capacity for the extreme risk contained within the South West Ambulance Service and the Ambulance Region’s departments.

“This is putting lives at risk with increasingly long waiting times for Category 2 Ambulances and handover delays at the front doors of the Royal Cornwall Hospital and Plymouth University Hospital. There is contemporary evidence that this risk to life tragically resulted in death.’

National figures show ambulance response times in the South West were the worst of any region last month with category two patients, the second most urgent, waiting two hours and 25 minutes for an ambulance to respond. Such patients include those who have suspected strokes and heart attacks.

The document spells out plans to solve the problem of patients staying in hospitals by discharging them home to the community sector.

Talking to The Independent, Professor Alison Leary, said: “It is a place of despair, I agree. This is a high risk scenario. With so many unknowns, it will be better to understand how they mitigate these risks,

She added: “There are things in it that refer to, you know, calling people to make sure they haven’t fallen. If people are at such a level of risk that they need carers and that resource is not available, then that obviously puts people at risk.”

One senior staff member said: “If the patient’s needs are well articulated and they can match a suitable volunteer, this can work well (eg help with cooking or shopping). But to think that this is a magic bullet to close all the gaps in home care seems optimistic at best.”

A spokesman for two South West hospitals said the voluntary sector had been involved in discharges for “a long time”.

They said patients being discharged “have no clinical needs”, adding that “this service helps to transition people home after a hospital stay and if they require an assessment for any ongoing recovery needs, which is in line with national discharge guidelines evaluate”.

“The voluntary sector in Cornwall and the Isles of Scilly (CIOS) has a long tradition of supporting people who can be discharged from hospital but need support at home.

“We are now supporting this very valuable work by funding it as a sustainable service from Disability Cornwall and Age UK. Examples of how they support people at home include providing them with groceries, turning on the heating and getting them into their homes, as well as supporting them for as long as a few weeks.’