The risk of long A&E waits escalates with age in England, says a new report. Here is a personal view on that statistic in a reader’s letter about the distressing experiences of her very elderly mother.
Dear Editor,
My very elderly mother recently had a bad fall and ended up in an East Anglian NHS hospital for two weeks. Sadly, our experience could have been better.
Much was good: the ambulance arrived quickly; the excellent paramedics took Mum to A&E. We waited in an ambulance queue for over an hour for admission. The paramedics left when she was transferred off their trolley. I thanked them; they replied, “At least we only have one patient at a time to deal with, look how many they’re trying to treat in here.”
A trolley queue ran down the corridor, many occupied by elderly people with visible injuries, many with dementia like Mum. Joining the queue, they did her initial tests there.
After some time, we were taken for assessment and told she’d need a CT scan and X-ray. The wait was several hours purely because porters were in short supply. Eventually she stayed the night in an A & E bay as wards were full.
Two nurses came to moisten her hair and gently comb out the matted blood round the wound. Afterwards, she declared she “wouldn’t come to this hairdresser again”.
Next morning she was transferred to an assessment ward. The doctor understandably wanted to discharge as many patients as possible, knowing there were no beds for them.
But he decided a special scan was necessary, and as a result, she spent two distressing nights in the corridor in this ward, waiting for a bed bay. For a person with dementia, it’s confusing to have people walking past all night, frequent alarms sounding, not knowing where the toilet is. Next morning she said it was “like no holiday she’d ever been on”.
Finally, Mum was transferred to a ward. She had to wait a week for the scan because the radiography department was short-staffed. The eventual results were fine, but it was Friday, and they didn’t have doctors to discharge over the weekend so it meant taking up a bed till Monday. Meanwhile two more bewildered elderly ladies were on trolleys in the corridor.
On Sunday she was transferred to yet another ward, no reason given. She was eventually discharged on Tuesday, after two weeks. It seems to me that it could all have happened in a few days, but what do I know?
Luckily no bones were broken, unlike those with broken hips who’d be staying much longer. Recovery from her injury was quick, but recovery from the hospital stay took longer. Being immobile had weakened her, necessitating physiotherapy visits after discharge. And it was a draining experience for the whole family.
It was hard planning post-hospital care when discharge times kept changing and doctors were hard to find. Staff were all professional, patient and kind, but very rushed. All tried to provide good care, but we sensed that some seemed exhausted and had no energy to connect with patients or even each other. Nurses seemed to spend much time on computers writing up records.
An NHS hospital is a huge interconnecting web of departments supporting each other. Apparently it only takes one snarl-up in the web (lack of porters or scan staff) and someone can end up in hospital far longer than necessary.
“Bed-blocking” can be an issue in elderly wards. But this wasn’t a case where the person couldn’t leave hospital due to an insufficient care package at home, it was because of treatment delays in the hospital itself. It’s nobody’s fault, but it’s not the well-oiled machine it should be.
I know many have had similar experiences. Elderly, frail people are intensive NHS-users. Numbers of over 85s might double over the next 20 years as ‘baby boomers’ age. This is something the NHS needs to get right. There must be a way. People so want it to improve.
For the record, I’m a strong NHS supporter and hugely respect medical staff. My mother has recovered well, physically, and my family is grateful.
Yours,
A reader
PS. The government recently released data on the NHS showing that on many measures, there’s been some improvement. Undeniably good news, but I worry that the NHS may have to spend years ‘reacting’ to the existing mess, and won’t have the bandwidth to plan proactively for future needs. I hope not.
