Solving the scandal of bed blocking

BED blocker. It is a particularly crude term for someone who, while healthy enough to leave and be cared for in a stepdown facility, instead remains in hospital, using care services that by rights should be available to those more in need.

The term implies an element of blame on the patient himself or herself. Yet when you talk to any of them, their dearest wish is to be moved somewhere a little less regimented and a little more like home.

Within the HSE, the term used is ‘delayed discharge’ – and responsibility for the problem lies with the HSE itself. There is no justification for the fact that, according to the HSE’s own data, one patient has been waiting to leave hospital for over four years, while another 12 have been waiting over a year. The total figure for those ready to leave hospital, but unable to because there is nowhere to go, is 469.

Two negatives result from this. The patients become despondent, while others who need those beds cannot access them.

Reducing the number of delayed discharges is a key plank of Government strategy on health, and while the number of bed nights involved is dropping, the number of people affected is rising. Nor are the numbers updated frequently enough to be entirely accurate. Some months, there may be as many as 200 more people waiting for step-down care than appear in the published figures.

The effects are stark. With these beds in use, we could perform 107,000 hip operations or 100,000 knee operations a year.

The solution is obvious. Yes, we need more community care facilities but we also need stronger homecare protocols, so patients can be sent home. Those most likely to face delayed discharge are the elderly. It is vital we move away from hospital-focused care for those who do not need it, and instead get them in and out as quickly as possible, with the safety net of proper care once they leave.