Melody Redman: No more games please over NHS bed-blockers

Every day on ward rounds, I write in capital letters at the bottom of Mrs Johnson’s notes ‘Medically fit for discharge’ and add the number of days she’s been waiting. Being in hospital is no longer what’s best for Mrs Johnson but bed block or exit block means patients like her, who no longer need to be in hospital can’t be discharged because there is simply nowhere appropriate for them to go. This contributes to patients waiting for hours on trolleys or being admitted to an inappropriate ward for their needs.

Hospitals are increasingly becoming a holding place for elderly and vulnerable patients who should be being cared for in the community.

We see many patients like Mrs Johnson; well enough for home, but because social care is delayed, she is just waiting in hospital, just waiting to pick up an infection. Why do we see this problem in hospitals more often than we should?

As a child I was rather inquisitive, as my Dad so often reminds me. A short explanation or pseudo-answer was never enough; I wanted full and truthful answers. I wanted to know intricacies and detail, as far as a child could understand. Perhaps it is partly why I enjoy medicine; perhaps that attitude remains and is integrated in my character.

I think often with questions around the NHS, we’re treated like children asking “Why?” to the adults around them. We’re given pseudo-answers in an attempt for political parties to use the NHS to score points.

My first job as a junior doctor began eight months ago in A&E; an intense environment facing unprecedented pressure, where staff are facing unmanageable workloads, and are pushed to meet targets not based on a patient’s need.

Emergency departments are a
prime example of an area in the NHS where we’re not getting the answers we need. We’ve seen A&E departments across the country in crisis, with 17 hospitals declaring a ‘major incident’ over winter, owing to pressure on their departments.

As a response, emergency departments have received ‘emergency funding’; short term ‘solutions’, using recycled money from elsewhere in the NHS rather than a sustainable answer.

The problem we are facing is an overwhelming workload combined with staff shortages and inadequate resourcing.

The pseudo-answer we’re given? ‘We will provide an injection of funding’ (Please read as ‘We will recycle some funding from elsewhere, but we will not fix the root cause at the moment’). Why don’t we start looking at long term sustainable options?

Unfortunately in life, some things happen that we cannot explain. For some questions, we may never know the answers. But this is different; we need to ask the following: How are we going to improve social care in the community so that patients aren’t inappropriately kept in hospital when they are medically well? How are we going to ensure that A&E departments can be run sustainably and provide the best possible care for patients?

We are all affected by the NHS in
some way – think of your loved ones, or perhaps even yourself, who have had recent GP appointments, hospital admissions or treatment.

It is vital we keep political parties accountable.

We need real, sustainable answers, not pseudo-answers to try to score points. We need long-term investment planning and accountability.

You can ask questions about the
NHS. You can keep politicians accountable. The BMA has launched a campaign called ‘No More Games’. We’re calling for an open and honest public debate about the future of the NHS. We’re asking for you to join voices with us to say ‘No more games with our NHS’.

We really must combine our voices at this critical time in the run up to the General Election, to fight for a sustainable future of our NHS for us and our loved ones.

Names have been changed for reasons of patient confidentiality.

Dr Melody Redman is a junior doctor at Scunthorpe General Hospital. She endoreses the British Medical Association’s No More Games campaign over NHS funding - see nomoregames.org.uk for further details.