Chief presenter
It is simply earlier than 10:00 GMT on the Royal Free Hospital in north London.
Raymond Dubbery is 81 and affected by pneumonia. His hair thinning, he is frail and really skinny. The pores and skin hangs from his limbs. Transferred right here from his care dwelling, he is not consuming a lot.
The hope is he might be discharged quickly, however he does not like his care dwelling and does not wish to return.
Dr Khai Lee Cheah, guide in aged care, holds his hand. Raymond tells her he needs to stay someplace he’ll be completely satisfied.
“I take your level utterly,” she tells Raymond. “That your care dwelling ought to be someplace to stay, and never simply someplace to die.”
I am spending 24 hours on the Royal Free for a glimpse of the challenges dealing with the NHS because it grapples with intense winter pressures.
For sufferers like Raymond, who has no household, hospital workers have develop into social staff – a degree of human contact at a time when the social care sector is underneath pressure.
It is a dilemma for the medical workers, with 15-30% of sufferers on the Royal Free medically match to be discharged however unable to go dwelling, for a myriad of causes.
The hospital has its personal discharge group – whose job it’s to soundly get sufferers out of the door, to unencumber beds for brand new admissions. Slightly below 14,000 people who find themselves medically match are nonetheless in English hospitals and may’t go dwelling, by way of no fault of their very own.
On the Royal Free London Belief, there are 275 folks occupying beds who needn’t, at three main websites. That makes up practically 20% of all of the beds the belief has.
Faye Rogers, on the discharge group, has been on the telephone with a removals firm. She’s making an attempt to get somebody to go to the house of a affected person to shift a wardrobe within the bed room, to create space for a necessary hospital mattress.
“That is the sort of problem we have now to take care of on a regular basis,” she says.
“Generally a member of the family has the keys to a affected person’s home, they usually’ve gone on vacation. Some sufferers overlook the important thing code to their entrance door, so nobody can get in. The issues are mundane and routine however make it troublesome for folks to be discharged they usually’re an everyday prevalence.”
As evening falls, corridors filled with sufferers
Mid-afternoon is well the quietest time throughout our 24 hours on the Royal Free, with a number of the ambulance workers we come throughout cautioning that issues will change as day turns to nighttime. And they’re proper.
From round 8pm, increasingly sufferers flip up at A&E, on foot and by ambulance. All of the evaluation bays the place sufferers are triaged on arrival refill shortly and are in fixed use for the subsequent 5 hours.
That results in a spillover into the corridors, with sufferers in wheelchairs, on hospital beds and gurneys filling all of the out there area. The wards on both facet are full too. It is cramped and miserable – however a well-recognized scene in hospitals proper throughout England.
At round 10pm we come throughout Cathleen Hill who’s 86, sitting in a wheelchair amongst these within the hall. She has a facial damage and a bloody nostril.
She tells me she arrived on the hospital seven hours earlier. She has already seen a health care provider however is now having to attend. Her white hospital bib, tucked into the collar of her gray jumper, is splattered with congealed blood.
I ask her if she’s with anybody. “No, I have been right here alone,” she tells me.
“By yourself, the entire time?” I ask. “Sure,” she says, resigned to her predicament.
Lower than 5ft (1.5m) away within the hall a person mendacity on a gurney begins to groan. Islam Iskau, who’s 72, is carrying an oxygen masks and is grimacing from pains in his leg. He has been ready within the hall for round three hours.
His moans and groans develop louder, as he writhes on the gurney. Ultimately a good friend who’s with him manages to discover a nurse to get him some painkillers.
For sufferers ready within the hall, there isn’t a privateness. Some may argue no dignity both, with their ache and illnesses, oxygen bottles and intravenous drips all on public show.
Then instantly, an emergency alarm goes off. A affected person in one of many wards is having a seizure. The docs and nurses on responsibility, skilled as ever, head straight for her mattress, at the least six or seven folks. They should get her to the resuscitation space quick, to save lots of her life. However they’ll barely make their means out of the ward, due to all of the sufferers within the hall.
A bit of later an ambulance drops off a person with psychological well being issues, who has minimize himself within the decrease stomach with a knife. Regardless of the self-harm and his psychological state, the ambulance workers inform the on-duty nurse that the skin psychological well being evaluation service CASS, had refused to intervene, saying the affected person wasn’t in disaster.
The responsibility nurse shakes her head in disbelief, writing down the small print. As soon as once more the Royal Free’s A&E is being left to hold the can for one more company.
Resident physician Charlie Corridor, who’s on responsibility, tells me he comes from an extended line of docs. “It is not the well being service I signed up for, on the age of 17,” he says.
“The entry to providers, I really feel, are creaking for sufferers and the flexibility to offer high-quality care is creaking. Loads of sufferers are very dissatisfied with what is going on on, and I do not blame them. We’re doing our stage finest within the hospital to provide them one of the best remedy and one of the best choices, however you may solely apologise a lot.”
When our filming is over, we be taught that Raymond Dubbery has died on the ward.
For simply 24 hours, we noticed the NHS up shut, preventing uphill battles daily.
