Following comments yesterday about the recruitment of non qualified staff to deal with the current A&E crisis, we have been looking further at the issues that are behind the problems. Some reports maintain that there are growing difficulties in patients obtaining GP appointments, particularly out of hours or at short notice and that as a result of poor access to family doctors, emergency A&E departments are having to cope with a continuous rise in arrivals, with figures of up to 1 million a year quoted. 

Other reports suggest that a significant part of the problem is due to patients ‘bed blocking’ hospital beds. These patients are deemed fit to leave but reports maintain that as a result of inadequate social care support, ie a lack of care home beds and a shortage of support to keep people healthy at home, occupants cannot be safely discharged despite being well enough to go home. 

Statistics reveal that half of hospitals reported that at least 10% of beds are taken up by bed blockers. As a result of the delays in discharging patients, this has forced operations to be cancelled due to limited resources. Concerns have reached a definitive high, with Addenbrooke’s Hospital in Cambridge, one of the largest hospitals in England, stating that 87 of 1,000 beds are filled with such patients. One has been there for 72 days after she was declared fit to leave and another for 59 days. 

Natalie Churney, associate in the clinical negligence team at Penningtons Manches LLP, comments: “It seems that cuts to social care have had a negative knock on effect on the capacity A&E units can tolerate. The problems associated with bed blockers have resulted in patients being put on wards that are inappropriate for their needs, such as surgical wards for a medical patient. It has also made it harder for the NHS to meet waiting times for planned surgeries along with reducing elderly patients’ chances of being successfully rehabilitated. Additionally, waiting in hospital for care to be arranged not only reduces an older person’s chances of recovery but is profoundly upsetting for them and their families. 

“There are concerns with the inadequate level of social care support, a lack of organised after care and the reduction in social care funding. This has led to a significant problem for the NHS both in terms of the complications that arise from patients staying in hospital long term and their compromised ability to service A&E and routine surgical requirements. At best, this leads to delays and at worst to mistakes, lost chances for treatment and, in some cases, fatalities.”