dazza wrote:RDR wrote:In this case, no beds was the cry, so add the 5 hour wait, on a trolley, to see a medic, to the further 2 hours till a bed could be found, meant 7 hours on a trolley in total. She's a young women, so bad enough for her, but not exactly brilliant for the older generation.
That IAU is a hoot. Nursing staff rushed off their feet, nobody who seems to be in overall charge and confusion all round...
I've recently came into possession of a list of every Scottish hospital and their bed complement (circa 2007), and it makes for some interesting reading. The new QEU "super" hospital has between 1,109 - 1,677 beds depending on your source, however, the 2007 figures for beds are as follows:
Southern General - 900
Western Infirmary - 493
Victoria Infirmary - 400
Mansionhouse Unit - 252
Total 2,045
Taking into consideration that Gartnavel has already relocated five inpatient wards to the QEUH, and obviously intends to move more, that's a further 465 beds if all inpatient services cease. And if we thrown in Stobhill, which only closed in 2011, that's a further 543 beds which have already had to be absorbed elsewhere.
So Dazza, you point out what is very obvious and what the Health Board likes to deny i.e. Glasgow has less acute beds than it used to have....but does that matter?
It takes ten years to plan, build and deliver a new hospital and actually the new South (I refuse to call it QEUH, as nobody ever agreed to that title), took longer than that to plan as originally it was going to be just a hospital for South Glasgow, replacing the VI & SGH and not the OmniHospital it became.
When they planned it they made the following assumptions:
1. more people could be treated on a daycase/opd/community basis rather than occupying an acute bed. (95% of as patients contact with an acute site is via an OPD appointment rather than an inpatient episode.
2. Length of stay (LoS) could be reduced. In other words a patient would stay for a far shorter period than before. For example in years gone by a patient with a heart attack would be kept in bed for 3 weeks, rather than some patients now, who have been stented being kept in for only 24 hours.
3.Bed Occupancy could be increased. So typically a bed might be in use 60% of the time and you increase that up towards 100%, hence you need less beds. Sweating the assets as a capitalist might say.
4. new technology/treatment modalities reduce the need for inpatient care or LoS
Lot more than just the above but that gives you a flavour of it.
What they don't seem to have fully thought about is the fact that an aging population ends up with multiple problems to get treated time and time again, with multiple admissions.
The fact is direct A&E attendances are pretty stable, the vast increase in numbers are direct referrals in from GPs, which is why that IAU (and the AAU at GRI were created) to stop gumming up A&E.
Of course one major idea about the IAU was that folk wouldn't be admitted from there but could be diagnosed, treated and sent home.
Interesting that a hospital that took over ten years to plan, they still with 3 months to go before opening hadn't actually fully decided/agreed how patient flows might work through the new building.
So does it matter there are now less acute beds in Glasgow, than there were before? I'll let anyone who reads this try and work that one out
BTW Stobhill doesn't really impact on the South as the Stobhill beds were re provisioned within GRI, though not all of them, hence GRI ended up opening at least two extra wards (might be more can't remember), expanded the A&E, AAU and ITU but does face the same bed pressures as the new South.
He advocated for the weak against the strong, the poor against the rich and labour against capital.