A SHORTAGE of carers is putting unprecedented pressure on hospital beds, according to the Island’s medical director.
As many as 50 patients are remaining on wards – even though they are medically fit for discharge.
The staff shortage is causing further delays to operations at the Hospital, with the number of people on the waiting list for trauma and orthopaedic procedures surging by 42% between November 2021 and April this year.
Jersey’s medical director, Dr Patrick Armstrong, was due to meet clinicians at 7.30am today to discuss different options for using bed stock, including accommodation previously set aside for isolation, which could now be used for surgical cases as the need for Covid-19 provision is relaxed.
In recent weeks, as many as 50 patients medically fit for discharge – occupying almost a third of all short-term beds – have had to remain in hospital because there are too few carers to support them at home or in nursing homes.
Dr Armstrong admitted he had never seen such pressure on beds at this time of the year.
‘We are working in more difficult circumstances than we’ve seen in the past. We’ve never had so many people medically fit for discharge.
‘In the past, we’ve been running between 15 and 20, and if you are getting over 30 it will be significant. We are generally running at over 30 and peaking at 50 at the moment, which is very unusual at this time of year,’ he said.
Last year, then Hospital and Community Services managing director Rob Sainsbury said between 20 and 25 patients were waiting weeks to be discharged from hospital.
The JEP revealed last week that one consultant had written to a patient in May acknowledging that ‘numerous patients were now in considerable trouble with painful joints and progressive disability’ as the Hospital was struggling to carry out ‘any joint-replacement’ operations.
Asked about the morale of consultants, Dr Armstrong – an orthopaedic surgeon – conceded that the situation was ‘very frustrating for surgical colleagues’, but added there were different demands on beds within the hospital.
‘Ultimately, it’s got to be a compromise to do the best for as many people as we possibly can. We are working in more difficult circumstances than we’ve seen in the past,’ he said.
Dr Armstrong said that the challenges were exacerbated by the physical limitations of the current hospital building and by the shortage of single rooms – both important factors in limiting the threat of post-operative infection. But he described the Island’s shortage of carers as ‘the real pressure’.
‘That often comes back to staffing levels in those organisations which are often outside our control,’ he said.
While the new Jersey Care Model – and calculations about the optimum number of beds for the new hospital – are based around decentralising provision, the extent of the current challenge reinforces how dependent the Hospital is on the success of the partnership with other agencies in the community.
Dr Armstrong said he did not accept that this meant the new Hospital should have more beds, because those patients affected by the shortage of carers did not actually need to be in hospital.
‘We need more beds within the system. It’s a slightly different thing. Staff need to be in nursing homes and residential. Is that a market that HCS needs to get into themselves? Ultimately we are going to have to look at how we attract people to those roles and whether that’s easier for us as a government organisation to do, but that requires investment in health.
‘There have been no real discussions about that but it’s where our thinking is getting to,’ he said.
Meanwhile, Dr Armstrong also acknowledged that some patients requiring specialist care from hospitals in the UK were also being affected by the ‘catch-up’ which the NHS was facing after the pandemic.
One patient whose travel had already been arranged by HCS for a consultation in the UK less than a week later saw their appointment pushed back by six months.
However, Dr Armstrong said that HCS had a clear message for the general public which he wanted to underline.
‘[It] is that if you are experiencing severe issues and difficulties, always try to get in touch with us or with your GP. Don’t sit back and think that there’s no help available.
‘There will always be emergency help available and we will do as much as we possibly can for as many people as we can within the resources we have available to us,’ he said.
The JEP has been asked to clarify that at the time this newspaper ran a previous story on hospital waits (6 June), an interview had been requested and arranged with Dr Armstrong.
