I am writing this on a Friday afternoon, roughly one hour before I and my colleagues at Greater Manchester practices are again left to pick up the tab - as hospitals are pressured into discharging patients to meet targets.
Those patients include the frail, the elderly and the vulnerable. Most of them would have paid tax so that the NHS could survive and thrive. Some of them may have served their country in different roles, worked hard, obeyed the law and brought up children. And yet this current government seems to see them as merely a 'bed-blocker' who should be shunted out of hospital as quickly as possible, regardless of whether they are fit enough to return to a community where social care has been cut to the bone.
For our hardworking hospital staff, this situation must seem abhorrent. They joined a caring profession because that is exactly what they wanted to do – care for another human being. Their priority is the health of patients, not making sure REAP levels (Resource Escalation Action Plan) don’t get any higher.
GP workforce crisis
GPs and community nursing teams cannot deliver the quality of healthcare a hospital can – however dedicated they are to 'care closer to home'. For starters, they do not have the resource. As health secretary Jeremy Hunt will no doubt be aware, we already have a shortage of family doctors; and medical students are shunning the profession or planning to practice it overseas. Put simply, family doctors cannot – and should not – have the extra burden of caring for people who should be in hospital.
Cuts to social care leaves one wondering what these discharged patients are returning to – a cold home, no food, no one to look after them? It is a frightening scenario.
A missed opportunity to address some of these concerns came with the recent publication of Lord Carter of Coles’ report into that repulsive term 'bed-blocking'. Instead of headlines calling for the 20% of empty hospital posts to be filled (where was the recommendation for a national campaign to recruit Band Five nurses for example?) we simply had more arguments for cuts to pharmacy staff and the better utilisation of space.
Since raising concerns about rushed discharge, I have been inundated with GPs saying they are experiencing the same problems. Healthwatch England produced a report last summer claiming that 1m patients had been re-admitted to hospital within 30 days of discharge because they had been rushed out of the door. I have learned about hospital trust Christmas campaigns to get corporate staff involved in assisting patients to get home quickly and even the case of a Southend family who believe their local hospital was bullying patients out of hospital in a bid to solve their bed crisis.
Cleary this topic has hit a nerve and it is now my hope that people will make a stand against and put the safety of patients before any target, quota or number. Because if we continue to place the burden of caring for the seriously ill on the already beleaguered GP, the safety of our patients is at significant risk.
Dr Zahid Chauhan is a GP at the Medlock Medical Practice in Failsworth, Greater Manchester, and Labour councillor for Oldham Council's Alexandra Ward. He is also a non-executive director for BARDOC (Bury and Rochdale Doctors out-of-hours service) and NWAS (North West Ambulance Service).