NHS Wales: Patients can be sent home without care packages to free up beds - Welsh Government

The Welsh Government said there is a need for hospitals to consider discharge arrangements that "may not be perfect". Credit: PA

Some patients may be sent home from hospital without care packages in place as the Welsh NHS faces "unprecedented" demand.

In a letter sent to health boards, the Welsh Government said there is a need for hospitals to consider discharge arrangements that "may not be perfect". The letter continued: "A care package may not yet be in place and social care assessments may need to happen at home rather than in hospital."

The letter added: "Our hospital capacity must be preserved for those at greatest risk with greatest chance of benefit."

The letter, sent on December 30, acknowledged that the health service was facing "exceptional pressure" due to Covid as well as rapid increases in other respiratory viruses.

The NHS is under "unprecedented" strain due to Covid and flu infections, the Welsh Government says. Credit: PA

The Welsh Liberal Democrats have described the decision as "deeply concerning" and suggested many patients could end up being readmitted if adequate care packages are not put in place.

But a Welsh Government spokesperson said the move was intended to free up beds for those requiring urgent care, adding: "In some cases this may involve being cared for at home and we have asked for family and loved ones to help where possible."

On Tuesday (January 3) Swansea Bay University Health Board said it had 280 patients - the equivalent of a hospital the size of Singleton - who are medically ready to be discharged, but for a number of reasons could not go home.

The delay in medically well patients leaving hospital is often is because they are waiting for care packages or re-ablement support to be arranged, meaning they stay in hospital days or weeks longer than clinically necessary.

That in turn means beds can't be freed up for those needing urgent care.

Speaking on Tuesday (January 3), Dr Rhodri Edwards, Swansea Bay UHB Clinical Chair for Medicine, appealed for families to help wherever possible in order to facilitate a safe discharge.

Dr Edwards said: "We are asking families to get together and work out if they are in a position to help their relative to go home earlier.

"It would be really helpful if they could find ways to provide some temporary support for a short period, just while the care or re-ablement packages are being organised.

"This will not only be a great help to the NHS by helping us free up more beds for sick patients who are waiting for them, but it will substantially benefit their relative.

"Hospital really isn’t the best place for someone who no longer needs acute care.

Swansea Bay Health Board says it has 280 patients - the equivalent of the whole of Singleton Hospital - medically able to be discharged. Credit: Media Wales

"There is a real risk to patients staying on in an acute hospital bed that they will catch an infection from sick patients. Or they can become deconditioned - begin to lose strength and ability – by not being up and about enough.

"Prolonged hospital stays often lead to loss of muscle mass and other side effects like constipation and falls, so the sooner a patient is home the better."

The Welsh Government said it has made more than 500 extra community beds and packages of care available this winter to help discharge people from hospital, and is working on delivering more.

'Never been this bad'

On Monday (January 2), Betsi Cadwaladr University Health Board (BCUHB) in north Wales declared a "critical incident" across its hospitals caused by unprecedented demand.

Dr Phil Morgan, an Emergency Medical Consultant at Ysbyty Gwynedd, said the current situation is "grim, overcrowded and stressful."

According to Dr Morgan, the situation "has never been this bad."

He told ITV Wales: "The whole system isn't properly resourced and it's very difficult to keep going at the moment.

"It used to be a big deal when there was a four hour wait to move a patient to the ward, now it's a four day wait."

Wales' Chief Medical Officer Frank Atherton said Wales' hospitals were under unprecedented pressure before the new year as health boards across the country urged people to avoid emergency departments unless they were experiencing life threatening illness.

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