"The B word"

I will say first I despise the term Bed Blocker and the concept of bed blocking but on this occasion I honestly cannot think of a meaningful alternative.

My father was brought in to A&E a couple of weekends ago and after being assessed was placed on Ward 28a with four other gentlemen with enhanced care needs. (It was a four bed bay but there was massive pressure that weekend and staff showed great enterprise and energy in dealing with it).

1. My father was found medically fit for discharge on Monday rounds and this is where the major difficulty started. I found subsequently that the chain of events was that, despite numerous phone calls and conversations with staff asking that my father's discharge be expedited a referral was not made to social work until Tuesday and then sat unheeded. I even suggested that I would be happy to take him home as per ward policy and come back for any investigations/check ups he might require but this was ignored. Meanwhile my father, who is on immunosuppresants and only mildly affected by dementia, was occupying a bed on the ward. By Thursday I am afraid I lost patience and closely questioned the delay. When I was told to speak to the duty desk social worker I did and she did her very best to expedite my fathers discharge, however by Thursday evening his TTAs were still unavailable so I waited overnight. On Friday I was told that they were not ready and conceivably would not be ready that day either. I ascertained that there had been no significant additions or subtractions from his dossett, and came to the ward and took him home. I simply do not understand how this delay of 4 bed nights, 5 days, could have been allowed to accrue.

2. A secondary issue I had was that mobility was severely discouraged and there was massive reluctance to my getting my father mobilised with a walker. Whilst I appreciate the inherent risk for very many people with dementia my father and I have been managing his health for many years now and immediate and effective mobilisation is crucial in preventing deconditioning. I do not understand the resistance I met and feel this is far too close to defensive practice for comfort and may be harming people who would benefit from less passive care.

3. He lost a hearing aid. This happens all the time at home (the reason he only came in with one) and probably was caused by it being wrapped in tissue and thrown away. I find that confusion is severely aggravated by loss of spectacles and hearing aids. I don't honestly know how it can be avoided but just wanted to flag up the importance of these things.

4. I don't know what the policy is regarding use of personal mobile phones during shifts but I was concerned that on every occasion when I visited the member of staff on permanent station in the enhanced needs section made quite extensive use of their mobile. Four men with enhanced needs are a never ending source of need for conversation, interaction, attention to personal care needs and I think that use of mobiles in such circumstances is to be regretted.

I love the new hospital. I appreciate the environment and as always the staff in A&E and MAU give a really first class service for which Dad and I continue to be grateful. However judging by a poster on the wall talking about delayed discharge issues being escalated to management and a gentleman on the ward phone who was up and about and desperate to go home complaining about delays (obviously I have no idea whether the delay was anything to do with hospital process but the coincidence was concerning) both point to our experience not being a total exception.

When there are complex issues to be resolved to get people safely home I can see how delay is better than undue haste, but when there is a long history of house adaptations and a committed and experienced family carer prepared to stay with someone until their care package kicks back in (which I did over the weekend because it was too late for the agency to pick back up, incidentally! ) I struggle to understand and accept the delay. Someone other than my father needed that bed and that excellent care. Next time it might be him stranded in need because someone else is not experiencing appropriate expedited discharge. I hate to characterise this as a complaint, but I would like to know that the issues are going to be addressed and any material outcomes from it.