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 residence, he isn’t consuming a lot.
The hope is he could possibly be discharged quickly, however he does not like his care residence and does not wish to return.
Dr Khai Lee Cheah, marketing consultant in aged care, holds his hand. Raymond tells her he needs to dwell someplace he’ll be comfortable.
“I take your level fully,” she tells Raymond. “That your care residence needs to be someplace to dwell, and never simply someplace to die.”
I am spending 24 hours on the Royal Free for a glimpse of the challenges going through the NHS because it grapples with intense winter pressures.
For sufferers like Raymond, who has no household, hospital employees have turn into social staff – some extent of human contact at a time when the social care sector is beneath pressure.
It is a dilemma for the medical employees, with 15-30% of sufferers on the Royal Free medically match to be discharged however unable to go residence, for a myriad of causes.
The hospital has its personal discharge workforce – whose job it’s to securely get sufferers out of the door, to unlock beds for brand spanking new admissions. Slightly below 14,000 people who find themselves medically match are nonetheless in English hospitals and may’t go residence, 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 almost 20% of all of the beds the belief has.
Faye Rogers, on the discharge workforce, has been on the cellphone 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 an important hospital mattress.
“That is the type of problem we now have to cope with 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 a daily prevalence.”
As evening falls, corridors stuffed with sufferers
Mid-afternoon is well the quietest time throughout our 24 hours on the Royal Free, with a number of the ambulance employees we come throughout cautioning that issues will change as day turns to nighttime. And they’re proper.
From round 8pm, an increasing number of sufferers flip up at A&E, on foot and by ambulance. All of the evaluation bays the place sufferers are triaged on arrival refill rapidly 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 house. The wards on both facet are full too. It is cramped and miserable – however a well-known 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 physician 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 by myself,” 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. Finally a pal who’s with him manages to discover a nurse to get him some painkillers.
For sufferers ready within the hall, there is no such thing as a privateness. Some would possibly argue no dignity both, with their ache and illnesses, oxygen bottles and intravenous drips all on public show.
Then all of a sudden, an emergency alarm goes off. A affected person in one of many wards is having a seizure. The docs and nurses on obligation, skilled as ever, head straight for her mattress, no less than six or seven folks. They should get her to the resuscitation space quick, to save lots of her life. However they will 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 employees 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 obligation 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 obligation, tells me he comes from a protracted line of docs. “It isn’t the well being service I signed up for, on the age of 17,” he says.
“The entry to companies, I really feel, are creaking for sufferers and the flexibility to offer high-quality care is creaking. Numerous 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 present them one of the best remedy and one of the best choices, however you possibly can 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, combating uphill battles each day.
