The main issue of concern which was highlighted in Patrick Carter’s report last week was the lack of bed spaces in the NHS and the cost of ‘bed-blocking’ to it – costing the NHS £900m a year. The fact is that we have a winter bed crisis and hospitals do not have enough beds for those requiring hospital care. While the report focused on getting the well-enough out of a bed hospital and in to community care or with family, little attention has been given to a patient’s actual time in a hospital bed. Most importantly, the care they receive while in that bed and how that care is given could lead to hospital beds being freed up faster.
My dad was recently hospitalised. He is 68 years old. My mum and I found that the nurses in emergency assessment were unable to spend a fair or reasonable amount of time feeding patients, especially when dealing with emergency and urgent care patients. She and I fed my dad as he was too weak to do this himself, and this was welcomed by the nurses. For those without carers or family to assist with feeding, I found this deficiency in their care and their diet worrying. Why is this government not addressing the issues of overstretched staff and the care they are able to provide to patients, particularly in light of this week’s third NHS junior doctors’ strike? And why is this government pushing these issue aside in the face of the bed crisis? The two issues are linked.
I am not a doctor, but I know that good nutrition is an important part of rest and recovery. At my local hospital in Dartford, the average cost of feeding a patient per day in 2014-15 was £9.34. This money, food and the opportunity to increase recovery times and reduce bed occupancy time is not currently being utilised if patients are unable to feed themselves. With over 50 per cent of patients admitted in to hospital being over the age of 65, like my dad, also belonging to the ‘bed-blocking’ generation, and with many of these patients not being able to feed themselves due to illness or infirmary, surely it would make sense to try to improve their care to help get them out of beds as soon as possible? It is too easy to simply push the blame on to local authorities for not being able to getting well enough patients out of hospital and into care in the community as a drain on hospital finances. We have a growing ageing population with care needs that both the NHS and local authorities are struggling to provide for, with a chancellor who cares little for the consequences, only the savings.
I am aware that we have already seen a review of hospital nutrition in 2013. Nevertheless, I feel we need a further review by this government of the types of food that hospitals are feeding frail patients, in addition to the care they are receiving at meal times. I observed last week that patients had only a small window of time to eat before care assistants returned to their bedside to clear plates and trays. Some patients barely managed a few mouthfuls before their trays were collected. Certain foods were also wholly unsuitable for them to eat without aid, such as whole, unsliced chicken breast, which I witnessed a ward of elderly and very ill men struggle to cut with limited nurse support. These are simple changes that could be made to help patients get the nutrients they need to aid recovery and also help reduce the time spent by some patients in beds.
Nurses and medical staff are under massive strain. We have now learnt that junior doctors will be made to work seven days a week, when they are already struggling with their current shift and work patterns. Bringing in more staff to take the away the strain would be costly; the average wage of an auxiliary nurses ranges between £15,100 and £22,236 pounds. However, more nurses and other staff would be required to help reduce a patient’s time in bed via palliative care. With the average cost of a patient in hospital being £225 a day, and with a bed shortage, surely the cost would be offset? If patients are stronger from palliative care and good nutrition, their need and time required in care in the community will also be reduced.
If this government and the NHS spent more on nurses that could assist with feeding these elderly or weak patients who are unable to feed themselves, patients would be out of beds quicker, helping to reducing the beds crisis.
In 1948 Aneurin Bevan said, ‘Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised’. Under this current government, the NHS staff and patients are being penalised. I know that my dad being in that hospital bed was a privilege that so many people around the world do not have. Healthcare comes at a cost but we should be investing and innovating in our NHS, not cutting funding to it and care services. Sometimes you have got to spend money to make money.
We need a Labour government that preserves our NHS and which understands how investment in better care and nutrition in hospital could help reduce a patient’s time in a hospital bed or in care.
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Daisy Page is deputy leader of Dartford Labour group. She tweets @DaisyPage07
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