The Perfect Storm

I was so impressed by what the NHS leaders in Liverpool were achieving Anya. It seemed that some seed capital would really have helped them turn things round but some NHS money would have to go to the council for them to do their part with the care.

I was a bit disappointed as I would have liked more hard facts about how things actually happened. The woman that was taken home by the frailty team didn't seem fit to be left on her own. Having said that, it seems a really sensible model.

Yes, there's a real will for change with the 'Healthy Liverpool' project among the NHS leaders there. The task now is to get the whole message out there.

One message that came through loud and clear, and I know this will not be popular with some, is that we all bear a responsibility to look after ourselves better.

They were there for six months Kitty so I wonder if they couldn't do some follow up programmes. I thought the idea of the frailty team was a good one but I can see what you mean about the lady who went home. He did say that they had to be prepared ... I can't remember how he put it but something like not always to take the safest option. It is certainly the case that with everyday an elderly person is in hospital they deteriorate. I felt it took us 18 months to get my mother over a two week stay in hospital a few years ago - and all they were doing was making sure her pain medication was right.

The idea of the interim stay hospitals for recuperation seemed a very good idea and could be run mainly by nurses with visiting doctors I would have thought. The people there seemed much less institutionalised and, of course would go home fairly soon.

The interim stay hospitals were an excellent idea. Not only were they cost effective, something like £700 a week pp as opposed to £3000 a week in hospital, but the patients seemed happier and therefore healthier.

All the mats on the old lady's kitchen floor were not a good idea. Did they carry out a safety assessment at all? Will she be provided with a round-the-neck alarm?

Typical all frills and no substance telly programme.

Anya I didn't like the bit about "people have to take responsibility for looking after themselves". What did he know about it? Illness can strike out of the blue no matter how healthily you eat, and how much exercise you do.

Weren't interim stay hospitals called convalescent homes? When DH started doing domiciliary visits our local teaching hospital sent older patients to an interim home where they were seen by OTs and physiotherapists etc. From there, they either went into an appropriate home or back to their own home.

I know that there always seems to be a panic around patients leaving hospital and getting in to a nursing home. We do need a joined up service but the NHS has to be totally rethought for that to happen and most people seem too scared to do that. Good on Liverpool!

It really is teaching grandma to suck eggs - we have all been here before. When I first started out as a hospital social worker, the convalescence and rehab for the elderly was good, and an OT visit prior to going home was the norm.

I ran a 2 year research project into getting elderly people home from hospital. I had a dedicated OT on board. One of the strategies that worked the best was when we trained up some carers to be able to stand back and assess the patient's abilities and needs in their own home for 48 hours. The carer would live in for those 2 days and the OT and I would go along at the end of the time and work out exactly what was needed to make a discharge home possible - in the meantime, I had an interim care place available if we needed it whilst the care was set up.

One of the best things about this was that it got the patient over that difficult time when they first went home when they lacked confidence in their abilities after a long stay in hospital.

All the people we worked with had been assessed as needing nursing home care, and 90% were able to return to their homes after taking part in the project.

The problem with good care in the home is that it cost money - the government seems to think it is the cheap option. But it is not - IF it is done properly of course.

I knew that the GP's idea that people should take more responsibility for their own health wouldn't be popular. After all, eating too much, sitting watching TV rather than getting out and doing a bit of walking, smoking and drinking too much won't affect your health will it?

Eat, drink and be merry then complain when the over-burdened NHS can't cope?

of course people can get sick 'out of the blue' what's that to do with anything?

Anya It really isn't a question of whether it is popular or not. I really do think it is more complex that you make out. Many of the "lifestyle" problems are associated with poor households. I think the fact that they are looking at taxes on sugary drinks is a start but, as we know, when everyone decided fat was the problem the food manufacturers stuffed their wares full of sugar to keep them cheap but still tasty. Food manufacturers have to start taking more responsibility.

Anyway, that apart, the consensus seems to be there is a lot to be learned from what Liverpool are doing. Nice and positive for once.

It's both more complicated and yet simpler GG

When I worked for Liverpool I was part of the Obesity Forum who was attempting to look at the issue of obesity (obviously! ) so I do understand the causes and effects of this problem.

The simplistic view is that if people would only eat less, eat better, move more, stop smoking and cut back on their drinking then they would be much healthier. And that is true, so simples!!

No, it's not that easy. One example we found in communities is the problem with local shops. Unless you were prepared to drive to the nearest supermarket (and many don't own cars) then your local shop was the best option. But these were not offering anything like a good range of fresh fruit vegetables, meat or fish. My own experience bears this out as whenever I was out of the office at lunch time, if I found myself in, for example, Litherland and stopped at the local group of shops, it was well nigh impossible to find anything approaching a healthy choice. Plenty of choice of junk food, cigarette, chocolates and alcohol though.

And that is just one example of how hard it can be.

Sadly I left and moved south so don't know the final findings of the Forum, though I suspect it fed into the Healthy Liverpool initiative as I recognised at least one face on the programme.

lovely to see Anthony Gormley's bronzes again on Crosby beach

I started looking at that but there was a horrible background drumming doom and gloom vibrating soundtrack on there which was making feel me feel weird. I am not good with things like that.
It took about 15 minutes of the presenter posing in different locations before they got going, at which point I switched off.

I haven't seen the programme but when the S.O.'s mother was in hospital for several months I lost count of the number of times he had an appointment with someone with a view to his mum going home and they either didn't turn up or, if they did turn up didn't know anything about the situation [one of them thinking the S.O. was his mum's husband]. There was constant talk of getting her back home [even once insisting that she went back to her house with them, even though she found it very upsetting]. I kept saying that there was no way that she was ever going to return home but no one seemed to see it . I just felt that throughout it all the right hand didn't know what the left hand was doing. With regards to obesity, I'm not sure what the NHS is doing to help people with impaired mobility to keep their weight down; it's very difficult to keep weight off when people can no longer exercise the way they used to.

Of course it's good to eat as healthily as you can. And to take exercise. No one is disputing that. (nothing to do with it being "popular" )

The fact remains that even seemingly well people can get ill, and to blame the patient cannot be the right thing to do.

"so simples". Yeah right.

Oh right. You qualified it. Soz.

Accept that a seemingly healthy person can suddenly get ill and no blame attached. But that's not what the issue is here.

If that was all the NHS had to contend with it wouldn't be struggling as much as it is.

But there are those who will jump on a poster if it is even suggested that some people bring ill health on themselves. The favourite scenario often is 'my friend/SiL/Aunt Mabel/Personal Trainer all exercised for 3 hours every day, ate nothing but vegetables and drank only liquified green algae, and they still got cancer/diabetes/distemper.

only saying

Yes; always a god idea to read what people have actually 'written' before automatically disagreeing with them [imo that is ]....

Soz accepted.

I think I'm arguing both sides against the middle here

I can't remember what that means.

Tegan - I do.

Perhaps you need to read my posts more carefully before commenting on them.

that was to tegan