One in five beds at the N&N now 'blocked'

Sam Higginson, cheif executive of the Norfolk and Norwich University Hospital. Picture: NNUH

Sam Higginson, chief executive of the Norfolk and Norwich University Hospital. - Credit: NNUH

The number of people stuck in the region's biggest hospital despite being medically fit to go home has trebled since pre-pandemic levels, with them now taking up one in five of the site's beds.

The Norfolk and Norwich University Hospital currently has 227 'bed blockers' - or patients "without criteria to reside" - its chief executive has told its board of directors.

These are patients far enough along in their recoveries that they no longer need hospital treatment, but can not be discharged until home or residential care can be arranged.

The issue highlights ongoing problems in the region's social care system, with staff shortages limiting the amount of care that can be provided.

And it, in turn, exacerbates the huge pressures already facing hospitals and the emergency services, with the consequences stretching all the way back to ambulance delays, as paramedics are forced to wait to hand over their patients due to lack to capacity at hospitals.

Sam Higginson, NNUH chief executive, told the board that the figure for 'bed-blockers' was now more than treble pre-pandemic levels.

The figure means that almost one in five of the hospital's beds is occupied by somebody who does not medically need it.

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He said: "We have been under real pressure for a considerable amount of time, which feels over the last 10 days or so is building again.

"Pre-pandemic, we would usually have around 70 patients without criteria to reside - this morning that figure has reached 227.

"This is putting massive pressure on our ward staff and on the emergency department.

"We have got lots of work going on internally and are doing everything we can to mitigate this in the hospital, but the real challenge is gaps in domiciliary care."

He said this work included moving these patients into beds on wards they ordinarily would not be placed in.

The hospital has also recently been forced into adding extra beds onto wards, caring for seven patients on wards of six to increase its capacity.

Mr Higginson said the home care gap was an issue in desperate need of extra funding, adding: "It is having a real impact on our patient and staff experiences."

Meanwhile, he added that the hospital was continuing to deal with "an increasing prevalence" of Covid, which led to the reintroduction of mask-wearing in clinical areas.

He said: "We saw a real increase in Covid cases in June and July. It is starting to tail off a bit now, but it is still at a level we hoped we would not be at again.

"We are continuing to review infection control measures and have reintroduced mask-wearing, which is something we will have to keep looking at dynamically."


Health reporter's analysis

The issue of hospital discharge delay is a long existing one, writes David Hannant, but one that has been highlighted even more in recent years.

It is one much more complex than simply being a by-product of the pandemic, but clearly the situation has been exacerbated these past two years - as is shown by this stark figure.

It is also a clear example of just how interconnected health and social care is - and why the new integrated system has to make sure it gets things right.

The problem is a prime example of a chain reaction that leaves insurmountable problems in its wake.

If home care can not be provided, its impact is much more severe than simply keeping people in hospital.

If hospitals can not get beds clear, emergency departments can not get patients on to wards, so ambulances can not get people into emergency departments.

This then creates delays in paramedics getting to emergencies which, ultimately, can cost lives.