Winter on the wards: helping the NHS to ease the burden of the cold season
The assisted discharge programme has been rolled out at hospitals up and down the country. But how has it made a difference to those who know the struggle best?
This story was first published in February 2020
Frosty weather. Flu. Failing central heating. And, this year, heightened fears over the spread of Covid-19. It’s little wonder that the term the NHS uses to describe an increase in patients in the colder months is ‘winter pressures’ - and increasingly, these pressures are being encountered at different times throughout the year.
In November 2019, the British Medical Association warned that the winter the UK was heading into was ‘a perfect storm’ following a summer that had been busier than even the BMA’s worst-case projections.
They were right. In January, NHS figures reported A&E waiting times and ambulance call-outs were both at record levels - a sign of the strain busy doctors, nurses and paramedics are under.
Busy wards and blocked beds
Life on the wards can be tense. Staff shortages, worried patients, and a lack of free beds can make things stressful for everyone - not least for overworked staff.
The problem is not only the amount of patients coming in, but also making sure patients who are well enough to go home, can do that safely.
©Percy Dean/British Red Cross
Alison, chief nurse and director of quality governance at Stockport NHS Foundation Trust
Waiting times in winter
“In the winter months it can be really difficult to get some patients help and support them to get them home as quickly as possible,” said Alison, chief nurse and director of quality governance at Stockport NHS Foundation Trust.
“Sometimes there can be a problem with organising transport to get people home; they might be waiting a while in our transfer unit, and that might not be the best experience for [them]."
So when Alison was approached by the British Red Cross’s independent living service team, she was all ears. The Red Cross works with more than 100 hospitals all year round and scales up this support in the winter. The offer was for Stockport's Stepping Hill Hospital to become one of them.
During these months, hospitals across the UK see an increase in admissions, particularly of more vulnerable people such as the elderly. Through the Red Cross’s assisted discharge service, teams work in hospitals to support those who are medically fit enough to go home, but who don't have anyone to pick them up. But it's about so much more than a lift home and a cup of tea when you get there.
The Red Cross brought in a team of seven staff and three volunteers to Stepping Hill. They worked closely with the hospital’s discharge team and helped settle patients safely and comfortably back at home.
“We’ve been absolutely delighted to have joined in partnership with the Red Cross, who have helped some of our really vulnerable patients get home safely and on time,” said Alison, after the service had launched at Stepping Hill. “I’ve really seen the benefits for our patients and staff. There was immediate trust and confidence in our abilities to work together as a partnership having seen it tried and tested before.”
One hospital it had already been tested at was Lincoln County Hospital, where the assisted discharge service had been a huge success.
An invaluable service
Kate, a matron discharge lead there, said the Red Cross’s support has been invaluable for both staff and patients. “It frees up nursing staff on the ward from running around calling relatives, packing bags and collecting people,” said Kate.
IT MIGHT SEEM LIKE A SMALL THING, BUT SOMETIMES IT'S THE DIFFERENCE BETWEEN A SAFE DISCHARGE AND NOT.KATE, MATRON DISCHARGE LEAD AT LINCOLN COUNTY HOSPITAL
Red Cross staff and volunteers run errands like picking up a patient’s medication from the pharmacy, making sure they have tea, coffee, and milk in the house, and that the heating is warm enough.
“Those are things that are absolutely vitally important, that we just can’t always do and that’s been, for us, one of the greatest benefits. It might seem like a small thing, but sometimes it’s the difference between a safe discharge and not,” said Kate.
Small things can often add up to complex problems. Red Cross teams have the time to spend with patients to understand what they need, and build up trust. They work with people to involve them in finding solutions they’re happy with, so they feel valued, and that they’ve been treated with dignity and respect.
After spending ten weeks working with the Assisted Discharge team, Alison has now seen the big difference those small (but crucial) acts of kindness can make and is keen for the partnership to continue.
“For us, this isn’t about winter pressures,” she said. “This is a really good piece of community work that we’d like to be involved in. Sometimes it’s just about somebody who can make a difference in someone’s life at the time of discharge and make them feel safe.”
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