A Cardiff GP has said new Welsh Government guidance for hospitals to discharge patients without care packages in place is "terrifying". Dr Sayma Ahmed, of Cloughmore Surgery in the Splott area of Cardiff, responded to the plans on BBC Radio Wales on Wednesday and believes they are not going to "fix" the 'bed blocking' problem in Welsh hospitals.
Wales' Chief Nursing Officer and Deputy Chief Medical Officer wrote a letter to senior NHS staff on December 30, 2022 offering "advice to support decisions to discharge". They began by acknowledging the "exceptional pressure" the NHS is currently facing - including more than 500 confirmed Covid cases in Welsh hospitals and "rapid increases in the other respiratory viruses not seen as usual during the pandemic" - resulting in "long delays in the provision of care, with their attendant risks".
The letter urged that "day to day clinical decision making must adapt to these exceptional pressures" and "our hospital capacity must be preserved for those at greatest risk with greatest chance of benefit." It continued: "This will require us to make every effort to keep people at home, not to admit people to hospital unless absolutely necessary and to return those in hospital to their homes or alternative place of safety as quickly as is possible."
Read more: Covid, flu and strep: How bad it got and how health experts expect them to hit us in winter months
It acknowledged that this "this necessary adjustment in the clinical risk threshold for hospital care may be concerning for some professionals," but urged: "The NHS will serve our population best if as many people as possible either remain at home or return home from hospital care as quickly as is possible.
"There will be a need for everyone to consider discharge arrangements that may not be perfect, a care package may not yet be in place, and social care assessments may need to happen at home rather than in hospital". Speaking on BBC Radio Wales, Dr Sayma Ahmed said the change of guidance was "terrifying".
She is concerned that if patients are well enough to be discharged but can't look after their basic needs - like take their medication, go to the toilet or feed themselves - they will return to hospital. "People usually need carers because they can't do those things day to day and if we can't help those people...eventually they are going to deteriorate and end up back in hospital," she said.
"In primary care, we're directly seeing these patients in their homes, we're dealing with them day to day. There are lots of patients unfortunately we do have to send in because they haven't been able to care for themselves and essentially they become unsafe or they are already unsafe...I can understand [the thinking] that what else are we going to do? This isn't going to fix it though."
Addressing the advice for patients not to to go to A&E unless "absolutely necessary", she told BBC Radio Wales the resulting impact on primary care had been "huge", with patients opting for the GP instead of waiting for "hours and hours" in A&E. "We've got lots and lots of patients that should be attending A&E - we're talking about chest pains, road traffic accidents - that are actually speaking to us instead. And that's adding to our workload, which is already absolutely unmanageable as well."
She added: "My plea on the back of that would be that if you do need A&E, please do go and wait in A&E." Responding to the new advice from the Welsh Government for discharging patients, Welsh Liberal Democrat Leader Jane Dodds MS said: “This news will be deeply concerning to many of us, many patients could end up being readmitted if adequate care packages are not put in place. There has been a systematic failure from successive governments over the last few decades to provide meaningful improvements to the social care system in Wales.
“Reforming social care was a key promise of the Labour and Plaid Cymru Co-operation Agreement, yet things appear to be worse than ever. We cannot solve the crisis in our A&E departments until the crisis in social care is solved. The Welsh Government must ensure that patient safety is protected throughout the health care system and that meaningful reforms to the social care system are forthcoming.”
A Welsh Government spokesperson said: “Due to the unprecedented demand on the NHS we have asked health boards to focus on safely discharging people who no longer require treatment in hospital in order to help provide beds for people who require urgent care and treatment. Discharging people who are medically fit to leave hospital and no longer require urgent care can benefit the recovery process by reducing the risk of infection and muscle wastage. Patients will only be discharged from hospital when it is medically appropriate and safe to do so."
Read next:
- Bed blocking concerns as hundreds of patients well enough to leave Welsh hospitals but can't
- People in Wales told to wear masks in public if they have a cough or sore throat
- 'My mum is terminally ill and her dying wish is to go to New York'
- Beating the back-to-work blues now the festive season is over
- What Morriston Hospital A&E bosses say you SHOULD NOT go there with as it faces 'extreme pressure'
