[oliwarner]

Babysitting? These are patients deemed medically unfit enough to bring in. Who's looking after them after they're turfed out the ambulance? Every bed in every bay in A&E is occupied, each with an allocated nursing provision.

Oh we just double the number of nurses? Yeah, but no. They don't grow on trees. The current ones don't stretch (we asked). You can't just absorb 20-40 patients into your acute departments without space and staff. The paramedics are acting as those staff, their ambulances the space. Yes it's far from optimal.

[makomk]

I don't really see how patients so severely ill that they need a bed in A&E with dedicated nursing provision could be discharged into community social care, though maybe I'm missing something...

[oliwarner]

About a third of beds are blocked at our local DGH by medically fit people who still require community care provision. These are people waiting to go home (or to a home) from an inpatient stay.

Until they go, A&E can't admit people through to the beds they're currently in.

Even if you lie to the population and claim you'll add 7000 beds this winter, those beds aren't staffed. We can't surge 5000 nurses and 2000 support staff out of nowhere. They're all busy.

[Griffinsauce]

Discharge the less ill people, free up a bed for the more ill ones.

It's all about throughput. You're only looking at the front while the problem is in the back.

[_benedict]

I think perhaps their point is that, if some of the patients not discharged are consuming a nurse budget that isn’t required (because they are healthy and can be discharged), then this nurse budget could be redeployed to those waiting in admissions. Not sure how reasonable this is, I’m sure the hospitals will have thought of it themselves. But it does seem particularly silly to have the paramedics stuck in place and unable to serve anybody who may be even more critically ill.

[_benedict]

Hmm, this seems to have been attached to the wrong parent comment, and I am now unable to delete it ¯\_(ツ)_/¯