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News and Comment April 2019

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25 April - Bed blocking. Barts Health NHS Trust haven’t a clue how to manage it

Cabinet Member for Adults’ Services Brad Smith and his Director Stuart Rowbotham have often said how their collaboration with the NHS reduces bed blocking by elderly people to one of the lowest in the country. There is no reason not to accept their word for it and perhaps they could sell their expertise to Newham University Hospital which is part of the Barts Health NHS Trust and in dire need of an injection of common sense.

Olive I mentioned ten days ago that my aunt, 99 in a month’s time, had broken her leg and it might curtail blogging for a while.

There could be no complaints about A&E on the day of admission (Saturday 13th April); the doctor told me they would have to pin the thigh bone back together the next day and warned me that if things didn’t go well she might die from infections.

But things did go well and 48 hours later another doctor told me what would happen over the next week or so.

She would be given at least a week of physiotherapy to get her moving as soon as possible, her house would be inspected to make sure it was suitable for her eventual return and Newham Social Services would have to be informed to arrange a care package. (†)

In the event she was given one or two days of physiotherapy before all the staff buzzed off for a four day Easter break. No house inspection was carried out and as far as I know Social Services were not informed, certainly I have had no contact with them.

The 26 bed ward appeared to be run by two nurses over Easter which proved to be quite dangerous when they were busy elsewhere while my aunt was trying to stand and head for the door on a broken leg.

At no time have I seen a doctor or a physiotherapist since A&E and the only accessible person with a title was the dietician who was concerned that there had been no bowel movement since the operation.

That changed while I was visiting yesterday afternoon.

Earlier in the week, in the absence of any information, I was guessing that my aunt would be discharged by this weekend so I made arrangements with the care company I have been employing for the past year to resume attendance from this coming Saturday but doubling their hours of attendance. My sister would also come up from Hampshire to be with her aunt full time for at least the weekend.

Yesterday afternoon (Wednesday) the old lady got it into her head that I’d come to take her home and was making serious demands such that I could not just walk away. I told her I would be in trouble if I just took her away but that cut no ice.

I found the dietician, the only person to be located within 20 minutes, and asked him if he would put on his best authoritarian voice and tell my aunt that she could not leave with me. As soon as he began speaking I headed for the door. However two ladies in blue, one dark and one light blue, appeared and told me that she would be discharged today. (Thursday.)

I said that wasn’t possible because the carers’ rota had to adjusted and my sister would need time to make her own arrangements. In terms of office hours I was given no more than two hours notice to bring forward the care package because she was going home anyway. A near 99 year old who lives alone and who I have not yet seen on her feet because of the lack of physios and who is constipated and still needs a catheter was to be dumped and deserted in a home with no fresh food by uncaring medics.

I phoned my sister to see if she could come up today (Thursday) but she had her own hospital appointment in Basingstoke. I said to my sister that the three medical staff just a few feet away from me “did not have a single brain cell between them”. Knowing that they hadn’t got a key to get her into the house I left them to it.

Today, unknown to me, the vicar, the churchwarden and another friend all visited together. They got there just in time to see my aunt waiting at the exit for transport home. No formal request to me to get her home, no check with the care company that they could attend - I rechecked with them and they had heard nothing - no walking frame or commode provided and no key to get her into the house.

When the three visitors protested that she couldn’t be left to fend for herself they said her son - they can’t get anything right - would have to sit with her all night and as one of the visitors said, wipe her bum as necessary. Do they think a 99 year old spinster who never even had a boy friend in her younger days should be subjected to that sort of indignity?

A doctor then showed up to say she had been looking after the 99 year old (I had seen the name Dr. Pratt on the notice above the bed) but admitted when questioned she had been on a week’s leave. I am told that the church warden said after she left “Pratt by name, prat by nature” to which the vicar nodded agreement.

The churchwarden gave me a running commentary of these developments by phone and did a first rate job of telling the incompetents where they were going badly wrong. I didn’t want to phone them myself as I knew I would be telling them exactly what I thought of them and things might get heated, instead I asked my sister to phone.

She could only get hold of a nurse who was persuaded that discharge should be deferred until Saturday morning and she would ring back confirmation when she had it; but so far as midnight approaches; nothing.

The care company still believe that there can be no discharge until they confirm a care package is in place and no one has asked them to do that.

I still haven’t heard anything from the hospital directly except that there was a Withheld number call to my mobile while I was driving this afternoon, so it went unanswered. Maybe that would have been the first formal advice of the discharge that had been attempted several hours earlier.

I already had three complaints lined up for hospital management, now there’ll be four!

The last thing I would want. Much better to pay for someone who really cares.


Related blogs
25 April 2019. • 27 April 2019. • 29 April 2019. • 2 May 2019. • 3 May 2019 1st part. • 3 May 2019 2nd part. • 6 May 2019 1st part. • 6 May 2019 2nd part. • 7 May 2019. • 8 May 2019. • 9 May 2019. • 10 May 2019. • 11 May 2019. • 18 May 2019.
The Omnibus Edition.


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