Beds

The government claims that beds occupancy rates in hospitals nationwide are running at roughly 85%. Let’s step aside from evidence based, studied, actually-remarkably-well-statistically-twisted information and get anecdotal and personal for a minute:

The claims that there are always beds available and that care is not compromised by a lack thereof are complete and utter bullshit.

I have just come off shift. I was on-call, clerking in patients on the surgical take. The surgical assessment unit (a ward that does exactly what it says on the tin) has six beds; patients come in (referred either from GPs or A&E), are seen by myself and either the surgical registrar/consultant, and are then either discharged home, sent to theatre, or admitted to the wards. They do not (they do not) sit on SAU all day because the entire trust is bedblocked. There is a sofa sitting in the corridor outside of SAU where patients who are waiting to be seen can sit. They were sitting there, I was at the desk, and there were no beds for me to examine them on, no space for me to clerk them in, and no beds in the hospital to send anyone on SAU to.

This is including opening the emergency overflow wards, keeping inpatients in the day surgery unit, and putting patients on inappropriate wards – surgical patients on medical wards, and vice versa.

One of my patients entered anaphylactic shock today – his lips puffed up and his throat began to swell closed. I gave adrenaline and oxygen, called critical care outreach teams, and fast-bleeped the anaesthetic registrar (one step short of a full crash call). This man is unwell, and unwell in the doctor-to-doctor use of the word – very, very sick. That was before he went off with an allergic reaction to an unknown antigen. He needed, (and still needs) an ITU bed. Sadly, ITU have two more patients than they have beds – that is, there are already two patients who have had to be cared for in theatres recovery because there is no room at the inn. They are getting their care, but you cannot stretch services this way. Occupancy rates for an ITU should run around an 80-85% average occupancy to be safe (that is evidence based) as it allows admission of acutely unwell and rapidly deteriorating patients. The ITU in my hospital runs an average of 95%, all year round.

It is not safe. There are not enough beds. Again and again today I have come up against the brick wall of bed shortages hindering my ability to take care of my patients. All over the hospital, others are running into the same problem. One of my patients has been sat in recovery now for 36 hours. I am frustrated and I am angry – not with the Trust, who actually do a damn good job of trying to stay on top of things, but with the government who cut and cut and cut and barefacedly lie to the populace that there are no losses to frontline services, no issues with patient care.

Let me tell them they are wrong. They are, through ‘efficiency drives’, directly responsible for cutting the quality of front-line services. At its most basic, they are responsible for putting lives at risk. Today I have been placed, my hospital has been placed, in a position where gold-standard care for our patients is not possible, and I am angry.

On the government, on the health policies of today: shame.

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You hear stories occasionally of patients being treated in corridors. Is it better to treat them in the corridors or not treat them at all?

That is not a choice anyone should ever have to make.

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