Hospitals “desperate” to discharge patients admit ambulance delays are “life-threatening”

Waiting for ambulance crews outside hospitals reached 26 hours in September (PA Wire)

Hospitals “desperate” to free up beds could endanger patients, The independent it has been said.

Experts have warned that NHS trusts are being forced into “risky behavior” in the push to free hospital beds and emergency departments.

It comes as new data reveals that waits for ambulance crews outside hospitals hit 26 hours in September, with more than 4,000 patients likely to have suffered severe damage as a result of the delays.

In the documents leaked to The independenthospital officials in Cornwall have warned staff that current pressures in its emergency care system combined with ambulance delays have “tragically resulted in deaths”.

The Royal Cornwall Hospitals Trust and the Cornwall Partnership NHS Foundation Trust said in the document that delays and waiting for ambulances in the emergency room were causing a “life-threatening” and that they were planning to start discharging patients into care as a result. of the voluntary sector.

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The paper stated: “The risk of such support not meeting all patients’ individual needs is likely to be lower than the risk to life currently experienced in the community when there are significant delays in delivery to the hospital doors.”

It comes when the North West Ambulance Service initiated an investigation after a patient died waiting in the back of an ambulance outside A&E, the Manchester Evening News reported.

In response to worsening emergency and ambulance expectations, NHS England has asked trusts to expedite patient discharge, with more than 10,000 patients expected to be discharged stranded in hospital every day.

Hospitals across the country have started using a model in which patients are moved out of the emergency room every two hours, regardless of the amount of space available in the wards.

Concerns have been raised that this model results in patient crowding in wards or patient “boarding”, which means that patients are not placed in the correct type of ward.

Dr Louella Vaughan, an acute physician in London and a senior policy fellow at the Nuffield Trust, warned that evidence shows “boarding” increases the risk of death by 2 to 4 percent.

NHS England instructed hospitals to reduce delays in getting patients from ambulances to the emergency room (Getty)

NHS England instructed hospitals to reduce delays in getting patients from ambulances to the emergency room (Getty)

Talking with The independenthe argued that national policy encouraging the transition to these models was potentially forcing trusts into “risky behavior.”

He said, “Every year we have a flurry of ‘Oh my God, this is going to be the worst winter ever’; every year, NHS England launches a series of things that hospitals should do quickly, without resources and without time.

He said the policies do not address the “underlying structural problems with recruitment, retention, capacity and care models.”

Dr Vaughan added: “Optics at the moment, that we are seeing people lying on the sidewalk for six to eight hours with a makeshift tent … is terrible. This needs to be fixed, but excessive nursing in a ward can to make elderly patients lie in their own urine and feces, and not get drugs, don’t drink water, they too die, they just don’t die in the public eye.

“It will be 10 years after Francis’ report next year [ into the Mid Staffordshire Hospital NHS Foundation Trust]. This has shown negligence in nursing through extended nursing services, and it is not the nurse’s fault. I am very concerned that this could happen with a forced flow model, when the structural problems underlying the lack of social assistance are not resolved. “

The Quality of Care Commission on Thursday warned that a “grid” in health and social care was putting patients at risk, as social care capacity and staff made it unable to meet demands.

Doctors across the country said so The independent that emergency department departments are “still overflowing with many fit-for-discharge patients blocking the flow.”

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

Another Newcastle doctor said: “We are desperate for discharge – it is so difficult to become frail elderly [patients] now out of the hospital. I think we’re about 100 [patients with] delayed transfer of care “.

‘A risk to life’

Leaked Documents a The independent revealed that the Royal Cornwall Hospital Trust and the Cornwall Partnership NHS Foundation Trust told staff in September: emergency of the region.

“This is life-threatening, with increasingly long waiting times for a Category 2 ambulance response and delays in delivery at the front door of both Royal Cornwall Hospital and University Hospital Plymouth. There is current evidence that this risk to life has tragically resulted in death ”.

National data shows ambulance response times in the Southwest were the worst in any area last month, with Category 2 patients, the second most urgent case, waiting 2 hours and 25 minutes for a response. ambulance. These patients include those suspected of suffering from strokes and heart attacks.

The document sets out plans to address the problem of patients stuck in hospitals by placing them in the care of the voluntary sector.

Talking with The independent, Professor Alison Leary, an independent health consultant and researcher at London South Bank University, said: “This is a place of despair, I agree. This is a high-risk scenario. With a lot of unknowns, it [would] better understand how they are mitigating these risks.

He added: “There are things in this [document] where they refer to people ringing to make sure they haven’t fallen. If people are at that kind of level of risk, where they need assistants, and that resource is not available, then that obviously exposes people to risk. “

A senior staff member from one of the trusts said: “Where the patient’s need is well articulated and can be matched with an appropriate volunteer, it can work well, such as helping with meal prep or grocery shopping. But to think it is a magic bullet for all gaps in home care seems optimistic at best. “

A spokesman for the two hospitals in the Southwest said the voluntary sector had been involved in the discharge “for a long time.”

They said discharged patients “have no clinical needs,” adding, “This service helps resettle people home after a hospital stay and if they require an assessment for any ongoing rehabilitation needs, which is in line with guidelines. related national resign to evaluate.

“The volunteer sector in Cornwall and the Isles of Scilly has a long tradition of supporting people who may be discharged from hospital but who need support at home.

“We are now helping this valuable work by funding it as a sustainable service from Disability Cornwall and Age UK. Examples of the ways they are helping people at home include making sure they have shopping, heating, and [providing] support with qualification for a few weeks. “

A spokesperson for NHS England said: “Working closely with local leaders, the NHS has agreed on a number of measures to help frontline staff, including 24/7 control centers, fall response, rollaway beds and extra call handlers, all aimed at increasing capacity and reducing pressure on hospitals ahead of what could be a very busy winter.

“The NHS constantly monitors a number of measures used across the country that help improve patient flow and support staff, so they can be easily shared and adopted by other hospitals where clinically appropriate.”

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