So I’ve been redeployed at work to support one of the 11 cells the NHS has set up to manage this crisis. My day job is in discharge and prevention, so we’re working to make sure as many people who can leave hospital do as soon as possible to free up capacity. A few things:
(Caveat: I’m not an expert, I’m not a clinician, I don’t know the answer and I hope I don’t appear smarmy. I’m just a person with two cents that I got from working in this field for a few years.)
One of the biggest reasons for delays in discharge and transfers of care is codified ‘family/patient choice’. Often we don’t want our family member to go home if we don’t think they’re 100% yet. We think hospital is the best place for them to be. This couldn’t be less true.
The impact of ten days in a hospital bed on an 80 year old is the same as 10 years of muscle loss. Not to mention infection risk. Since the winter of 2017, there has been a strong focus on trying to increase out-of-hospital discharge assessments.
Sending people home and finding out what continuing care they might need sounds counterintuitive, but not only is it the best thing for the person, right now it’s the best thing for the NHS. Hospitals aim for an 80% bed occupancy rate, meaning 20% of their beds should be vacant.
No hospital in the country has managed this for the longest time. Over 5,000 people are, right now, in hospital when they should already have been sent somewhere else - either to their own home or to a more appropriate care setting.
The NHS needs capacity to deal with a pandemic. We can’t magic up nurses, doctors, GPs, Occupational Therapists or epidemiologists. We can’t build a new hospital in 8 days. But we can do our best to make sure discharge and avoidable admissions are as efficient as they can be.
I won’t go in to how stretched the NHS is, or how it’s current existence is solely down to the exceptional dedication of front-line staff who work to their own detriment to make sure people get the care they need.
But I would say one thing - if you or someone you know is in hospital, or has planned to be in, or needs to go for a reason unrelated to COVID-19: please trust your clinicians to know what’s best for you. Trust staff who might say you need to go home and stay there instead.
We’re so fortunate to live in a country with truly universal healthcare, but it’s also one of the most complex healthcare systems in the world. It’s going to take time for large-scale, high-intensity changes to the way we operate to catch on and have an effect.
We all have a responsibility to do everything we can to prevent COVID-19 from peaking too soon and too quickly. That means planning your care around the needs of others, especially the elderly, the disabled and high-risk people. And washing your damn hands. To Jolene, by Dolly. 
