GrumbleSmiles

In anticipation of the usual winter crisis and shortage of beds, ideas for new ways of working are coming out of the NHS thick and fast.   Here are two pilots that could have real advantages for older people.

The first is a proposal in Norfolk, where there is a higher than average proportion of older people.   They are opening a separate emergency unit specifically for people over the age of 80.   An octogenarian speedy boarding kind of A & E, except the idea is you don’t board.   The hope is that they can assess and treat you quickly and get you straight back home.   If it works, it is a good idea, because many older people seem to get worse when they are admitted to hospital.  Apparently  14% of  Norfolks A&E admissions are over  80.

The second new approach being tried out in London is to use video phone consultations between patients and a call service to a doctor, which would give you access to a GP within 2 hours  — a sort of  now you see him now you don’t  virtual type of consultation.    That could certainly work for young people who don’t like getting out of bed.

Now if we tweak all that a bit.    Extend the age range for speedy non-boarding to include all people over 60.    Encourage/ require everyone else to use their mobiles rather than going to hospitals.   There would be very few people left who needed to go to A&E.

Another idea would be to send the doctors to visit the elderly in their own homes and maybe call them GP’s.

My last post wrote about NHS England’s whacky ideas about fixing obesity.

Now, here comes another one, this time to solve the bed blocking problem.   At any one time there are estimated to be 5,800 patients in hospital beds who don’t need to be there.     The problem is they can’t go home because there is nobody to look after them. Especially in winter.

In sunny Southend they have a novel idea —- fill up all the empty B&B’s.   It helps the local economy and emptys lots of hospital beds.  What could possibly be wrong with that?    Throw in a few microwave meals and the occasional phone call from a ‘qualified’ carer and you have a service that is at least as good as the care in Southend hospitals.

I am not making this up, it is a proposal being considered at Southend University Hospitals Foundation.   The Care Rooms idea will offer £50 per day/night to people who will provide beds to patients who can’t be discharged home.   It would save the NHS money and release a hospital bed for other patients.

Of course it will probably never happen.    It is too simple an idea to ever work in the paralysed, burocratic, risk-obsessed world of the NHS.    The clinicians will be concerned about infection, because hospitals are so, so clean compared to homes.    The trade unions will probably oppose it, because it is privatising the NHS again.    The British Medical Association will certainly object, because it is a change and they don’t like any change, unless it means more money for doctors.    The army of hospital managers will need several more managers to manage the B&B’s and will also worry about who will be blamed if someone gets ill again and sues the NHS.     No-win no-fee lawyers will already be standing at the hospital gates.

Finally, the politicians will kick up a fuss just to get themselves noticed.   They will raise all sorts of arguments initially, but leave enough room to claim they were always fully behind these innovative and imaginative proposals if they turn out to be successful.