The NHS/Outpatient Care System is well and truly broken. Currently (Jan 2022) 1 in 7 beds in the NHS are blocked because Care Packages and Provision cannot be organised for them to be safely discharged. The Covid-19 crisis and resulting staff shortages have not helped.
In a Kafka-esque twist NHS England has issued guidance as follows :
If a patient “with Mental Capacity” (sic) is refusing to leave Hospital because they do not accept the follow-on care offered, the Trust should follow local discharge policy which could involve legal action“.
“the process may include seeking an order for possession of the hospital bed under Civil Procedure Rules Part 55”
Note how responsibility is so neatly transferred to the local institution which has to to do the legal action, and bear the cost.
So, the patient is to blame if what they consider to be an inadequate Care Package is being offered to them !! Their dilemma then is to either accept the Care Package or be subject to legal proceedings to be physically removed from the bed. Inducing stress in this way when a patient may have genuine concerns AND be vulnerable would be callous.
There are solutions to this. A short term fix would be to use a staging post, as in the USA, where hotel chains are invited to build budget hotels near to Hospitals. These also offer non Hospital level medical attentio and the opportunity for families and friends to contribute to the support of their kin. We used to call then Convalescent Homes until they were all shut down the 1960s and 70s, apparently saving money but inevitably stoking up problems in the overall system.
The only real solution is to understand the flow rates right across the GP, NHS and Care systems and then match the resources to the tasks in each. Of course easier said than done, but any other solution would just be more tinkering and generate more chaos. This is a self inflicted management and funding crisis by the NHS and Care System, it needs sorting out SOON.
Blaming the Patients isn’t going to solve the problem.