Hospitals “desperate” to free up beds could be putting patients at risk, The Independent has been told
NHS trusts are being forced into “risky behaviours” in the push to free up hospital beds and A&Es, experts have warned.
It comes as new data reveals the waits for ambulance crews outside of the hospital hit 26 hours in September, with more than 4,000 patients likely to have experienced severe harm due to delays.
In documents leaked to the Independent hospital leaders in Cornwall warned told staff that current pressures in its emergency care system and ambulance delays have “tragically resulted in deaths”
Royal Cornwall and Cornwall Partnership Hospitals said in the documents that ambulance delays and waits in A&E were a “risk to life” and as a result they are now planning to begin discharging patients into the care of the voluntary sector.
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The document said: “It is likely that the risk of such support not meeting all the patients’ individual requirements is less than the risk to life currently experienced in the community when there are significant handover delays at the hospital front doors.”
It comes as North West Ambulance Service had launched an investigation after a patient died waiting in the back of an ambulance outside of A&E.
In response to worsening A&E and ambulance waits, NHS England has called on trusts to speed up the discharge of patients, with more than 10,000 patients who should be discharged stuck in hospital each day.
Hospitals across have begun using a model in which patients are moving out of A&E every two hours regardless of space on trust wards.
Fears have been raised this model will result in patients being crowding patients into wards or “boarding patients”, which means people are not being placed in the correct type of ward.
Dr Louella Vaughan, an acute physician in London and senior policy fellow for the Nuffield Trust warned evidence shows the “boarding” of patients increases the risk of death by 2-4 per cent.
Speaking with The Independent she said the national policy encouraging a model to these models was potentially forcing trusts into “risky behaviours”.
She said: “Every year we have a flurry of oh my god, this is going be the worst winter ever, every year, NHS England rolls out a suite of things which hospitals are expected to do quickly, without any resources and with no time.
She said the policies do not address the “underlying structural problems with recruitment and retention and capacity and models of care.”
Dr Vaughan added: “The optics at the moment, that we’re seeing people, you know, lying on the pavement for six to eight hours with a makeshift tent for that kind of thing, and that is dreadful. That does need to be fixed but over-stretching nursing care on a ward can result in elderly patients lying in their own urine and faeces and not getting the medications. not having drinks of water. They die too. They just don’t die in the public eye.
“It’ll be 10 years next year since the Francis report. That showed, neglect in nursing through stretched nursing services, and it’s not the nurse’s fault.”
“I’m very worried that might happen with a forced flow model when the underlying structural problems about lack of social care are not fixed.”
On Thursday the Care Quality Commission warned a “gridlock” in health and social care was putting patients at risk, as capacity and staffing in social care has left it unable to meet demands.
