Episode 5 - Tuesday 24 April
Episode 5 returned to the unprecedented demand for emergency admissions in winter 2018 and looks at how the wider health and social care system works.
The episode specifically looked at the complexities around discharge and the role of social care in supporting patients once they are medically safe to leave hospital.
This is told through the stories of three patients; 93-year-old Ray had dementia and needs a complex package of care to help him once he is back at home. A shortage of carers means that Ray was waiting for weeks to leave hospital.
89-year-old Jean had been waiting in hospital for two weeks for the package of care that will allow her to go home. Her flat needs to be de-cluttered before it is safe enough for her and the carers.
Four-month-old Spencer has spent all of his young life in the Paediatric High Dependency Unit. He was born with under-developed lungs and needs help with his breathing. With the right support and equipment, doctors have said he can go home. But the family’s two-bedroom flat is too small to accommodate the specialist equipment he needs and the carers who will need to support him round the clock.
Meet the team from Episode 5
The teams who work in respiratory medicine cover a whole range of conditions, treatments and support for patients in the hospital, as outpatients and in their own homes. In Episode Five of ‘Hospital’ we see the team based at City Hospital caring for Jean who came in to hospital with pneumonia.
The team includes a range of healthcare professionals from physiotherapists to specialist nurses to family liaison officers to consultants. We also have an international reputation for our research into respiratory illnesses. They work closely with other teams across NUH including the spinal surgeons to support patients after surgery.
About 10,000 people in the UK are newly diagnosed with a lung disease every week. Approximately one in five people in the UK will develop asthma, COPD or another long-term respiratory illness during their lifetime.
Lung diseases are responsible for more than 700,000 hospital admissions each year.
Asthma alone is estimated to cost the NHS over £1bn each year and lung diseases as a whole estimated to be in excess of £11bn.
This winter has been one of the busiest on record for the NUH respiratory team; in 2017/18 there has been a 23% increase in admissions to hospital for people with respiratory diseases.
Our severe asthma service provides care for patients from across Nottinghamshire as well as from local hospitals in Derby, Mansfield, Boston, Grantham and Lincoln.
At NUH we are also at the forefront of developing new treatments, drugs and therapies for people with respiratory illnesses like asthma. The NIHR Nottingham Biomedical Research Centre based at NUH brings together researchers using world-leading discovery science to advance knowledge and develop new diagnostic tools and personalised treatments for asthma, COPD, IPF and pneumonia.
Kate is Team Leader of the Children’s Occupational Therapy Team. Kate works with children in hospital to help them regain their independence following surgery or illness. Kate joined the Children’s Therapy Team in 2010 and previously worked with adults in the in the Emergency Department at QMC.
Kate really enjoys being able to build up relationships with the patients and the families. This enables her to be able to offer the right solution and care for each individual family.
Kate’s story in Hospital.
Kate and the Long Term Ventilation Team worked with PICU patient Spencer. They visited Spencer’s new potential home to check it was suitable and helped the family with their housing application, liaising with the County Council.
Professor Rowan Harwood Consultant in Healthcare of the Older Person
Rowan is a consultant working as part of our Healthcare of the Older Person services who maintains an active role in research and teaching.
He has worked at NUH since 1996 and was made an honorary professor at the University of Nottingham in 2006. His clinical and research work includes delirium, dementia, stroke, continence, rehabilitation, end-of-life care.
In 2009, following 10 years in stroke medicine, he embarked on a programme to develop and evaluate better ways to manage cognitively-impaired older people in general hospitals and other dementia-related research. He has written four books on stroke and dementia and 80 academic papers.
Rowan's story in 'Hospital'
Rowan is the consultant looking after 93-year-old Ray who is one of the patients who is well enough to leave but who is stuck in hospital.
Ray has dementia and needs a complex package of care to help him once he is back at home. A shortage of carers means that Ray has been waiting for weeks to leave hospital. After 10 weeks of waiting, social services do eventually organise a care package for him but doubts arise about his ability to cope at home on his own.
If you have a particular combination of needs, the system needs to be able to meet those needs. We can’t put him in a wheelchair and leave him out on the Derby Road and saying, “You don’t need the hospital anymore. That’s, you know, that’s neither humane nor responsible. It’s not the patient’s fault. It’s the system’s fault.