Blocked beds?

One of the problems that causes bed blockers is lack of Social Services funding. A lot of people are discharged with a care package at home, but there aren't always the carers to do this.

There are also long waits for an Social Services OT assessment, then installation of equipment. This adds to the risk of falls and hospital admission.

We have a number of community hospitals in our county for end of life and rehab. My DH has just been in one for 3 weeks after spending 6 weeks in one of the main hospitals.

I think, sadly, lack of nursing staff is also an issue.

I think if you're in pain, alone, perhaps you take what you're told at face value, which was unlike her in fact.

Allira

Aveline

Locally patients can eventually be offered 6 weeks in a local care home. However, patients that I spoke to were worried that they might just be dumped there with no choice and struggle to pay when the time ran out. That must cost local authorities a fortune too.

My cousin needed three weeks in a care home after a fall. She was assured it would be funded by the NHS but got an enormous bill afterwards which she had to pay.

Convalescent homes are an excellent idea.
Here the local hub hospital has a couple of wards which help to serve that purpose but the provision is far from adequate. If people need longer convalescence or therapy they are sent to care homes, often at their own expense.

Quite definitely conned there then. Was that promise to fund that 3 weeks a verbal one only (ie I guess they could get away more readily with saying "Whoops....silly us....inadequate training for that staff member that said that...but it is what it is and pay up") or did she have it in writing?

Makes sense that any promise of that nature should be given in writing - and then there's proof there (paragraph x, line y) that one could quote/go to MP about/send a solicitor letter etc and prove someone had been told the cost would be covered. Meanwhile - stay in hospital and refuse to budge until they "find the time" to write such a letter. Guess they made some sort of excuse for only telling her verbally (ie "We're too busy to type that letter right now - we'll do it tomorrow...oh whoops the day after....oh whoops the day after that" - so she had no proof?)

It sounds as if people need to be aware the NHS might make excuses/even tell downright lies just to stop any perceived "bed blocking" and not concern themselves with the welfare of the patient thereafter?

If our local authority is paying for 6 weeks in a care home at approx £2600 a week that adds up to a huge amount. Multiply that by the number of blocked beds and a convalescent hospital would be a bargain.

Aveline

That's shocking Allira. The patients I used to see were worried about where they might be put. I used to Google the various homes to show them pictures of the one they were to go to. SW assured them that there would be nothing to pay for 6 weeks. How awful to believe that and it wasn't true. It's so hard for these vulnerable people to advocate for themselves in these circumstances.

This was England and a few years ago, just before Covid. She had spent a couple of weeks in a convalescent home after an operation, then fell, went back to hospital then the supposedly funded care home, then got a bill on her return home.

We have a non general hospital which is of moderate size, larger than say a cottage hospital, where I went for physio after breaking my arm. I did ask my physiotherapist whether they had wards, a few apparently and for post operative rehabilitation. I agree with you Aveline a good provision.

My late mother paid for rehabilitation for a few weeks after a hip replacement, I don't know how much it cost, but she said the care she had there was excellent and she was happy to stump up for it.

That's shocking Allira. The patients I used to see were worried about where they might be put. I used to Google the various homes to show them pictures of the one they were to go to. SW assured them that there would be nothing to pay for 6 weeks. How awful to believe that and it wasn't true. It's so hard for these vulnerable people to advocate for themselves in these circumstances.

Aveline

Locally patients can eventually be offered 6 weeks in a local care home. However, patients that I spoke to were worried that they might just be dumped there with no choice and struggle to pay when the time ran out. That must cost local authorities a fortune too.

My cousin needed three weeks in a care home after a fall. She was assured it would be funded by the NHS but got an enormous bill afterwards which she had to pay.

Convalescent homes are an excellent idea.
Here the local hub hospital has a couple of wards which help to serve that purpose but the provision is far from adequate. If people need longer convalescence or therapy they are sent to care homes, often at their own expense.

Aveline

Locally patients can eventually be offered 6 weeks in a local care home. However, patients that I spoke to were worried that they might just be dumped there with no choice and struggle to pay when the time ran out. That must cost local authorities a fortune too.

I would worry about maybe getting conned in that position if I were them - a. That it might be awful standard (I've seen inside some awful ones over the years when visiting) b. They might be trying to con me into moving there permanently ("thin end of the wedge" tactics).

Yes staffing might be a problem but they wouldn't need acute hospital staff. Care staff managed by trained nurses would be good.
Just read that on in nine hospital beds are currently blocked. Freeing up those would allow places for acutely ill patients. Where are they now? Waiting in pain on long lists?

Aveline

The government rattled up the massive COVID hospitals quick enough. If they had the money for those surely the money could be found for convalescent/interim hospitals.

I imagine the problem would be staffing them.

Let's not forget that Tony Blair was very keen for private health care to be utilised.

Tony Blair's Labour government significantly increased private sector involvement in the NHS to cut waiting lists and boost capacity, introducing Independent Sector Treatment Centres (ISTCs) and fostering competition, a policy he continues to advocate for today to modernize the service, arguing it's vital for the NHS's survival against challenges like aging populations and stretched finances, despite past controversies and critiques of increasing privatization.

So not just under Conservatives

Grantanow - Exactly. Hospitals/ Convalescent Homes, are more than just beds - they need properly trained staff. Do not think ANY of the so-called Nightingale Units were ever used as there just were no staff for them.
Same with so-called bed blockers. Many patients waiting for firstly an assessment of their own homes for them to be able to return there, with (maybe) some adaptations- cannot be carried out due to nowhere enough qualified people to carry these assessments out. Or for those patients to require full-time care out of hospital in some sort of recovery unit, However, fewer and fewer of these still under NHS provision, so money has to be spent on using private ones, making large profits for some companies and individuals, but taking it from NHS/local authorities.

The continual and increasing privatisation of the NHS which has been going on over the past 12-15 years has resulted in the dreadful situation we now have - and is continuing and will get worse.

But most of the Nightingale units couldn't be adequately staffed and remained empty. Another BoJo fiasco.

Calendargirl

In our area, we have two ‘main’ hospitals, not big city ones, but reasonably sized.

When my next door neighbour (in his 90’s) fell at home and broke his leg, he was in one of those for a few days, then moved into a smaller hospital in a nearby town. Far too big to be classed as a cottage hospital, but much more suitable for a couple of weeks recuperation, physio etc.

Sadly, he never got walking again, and has been in a nursing home ever since.

But it seems there are a few of these smaller places where people are sent to recover from surgery and suchlike.

A good idea.

One in my town as well. It also houses some out patient departments, I've had physio there.

Aveline

Were some repurposed for joint replacement units? I don't know.

Ours in Devon is a shining example.
200 patients a day for diagnostics
80 patients a day for eye treatment
10 a day for orthopaedic procedures

It can work, and staff have been found from somewhere. Ours wouldn't have worked as a convalescent home though due to the fabric of the building.

I don’t think convalescent hospitals would solve the problem, as the fundamental issue is a lack of acute beds to cope with the volume of emergency and urgent admissions. Even if everybody who no longer needed acute care was moved to a bed elsewhere in the NHS acute hospitals would not cope with the peaks of activity. We already have community hospitals, which offer more services than convalescent units did, which are filled with complex discharge cases, and that is an issue of course, but it’s not the fundamental one, as there are not enough patients in acute hospitals for whom they are appropriate, given the average person is only in need of hospital care for a few days.

Were some repurposed for joint replacement units? I don't know.

And Arlene, what has happened to those hospitals? Are they still standing empty? They were never used were they or have they been pulled down? It’s all been an absolute shambles.

The government rattled up the massive COVID hospitals quick enough. If they had the money for those surely the money could be found for convalescent/interim hospitals.

As the population ages, this issue will grow.

Locally patients can eventually be offered 6 weeks in a local care home. However, patients that I spoke to were worried that they might just be dumped there with no choice and struggle to pay when the time ran out. That must cost local authorities a fortune too.

One nearish one to me got closed fairly recently.
Old building.
"Uneconomical"to repair.