Hospital Series Two

Episode
Episode Three
Broadcast Info
2017 (58 mins)
Description
This episode of the critically acclaimed series once again tells the human story behind the headlines, by analysing the links between Imperial Trusts’ hospitals and their social care partners in the wider community.
Every day of the week, St Mary’s Hospital must look after people who don’t need acute medical treatment but instead find themselves stuck in A&E or on a ward, waiting for a package of care to be arranged for them either in the community or at a specialist psychiatric hospital.
St Mary’s Hospital A&E in particular has seen a sharp rise in people arriving in crisis; those who don’t have anywhere else to turn.
This episode explores the daily reality and complexity of dealing with the many patients who find their way to one of Imperial College Healthcare’s hospitals hoping that the NHS can pick up the pieces. Until their care package or offsite psychiatric unit placement can be arranged, for their own safety and that of others, they can’t be discharged.
The Trust, in common with most acute medical hospitals, doesn’t provide mental health services and so has no designated psychiatric beds. Instead it relies on local Mental Health NHS trusts to provide care for patients with mental health problems in their own community or in-patient units. But increasingly, patients are waiting too long to get the specialist care they need.
In this episode, St Mary’s experiences one of its longest ever waiting time "breaches" - 95% of patients attending A&E in England must be seen, treated & then either admitted or discharged in under four hours - when a woman with serious mental health issues waits 29 hours for a psychiatric bed to become available. All staff can do while they wait is keep her safe in Room Q, the designated space for people in crisis, while the Psychiatric Liaison Team battles to find the specialist care she needs. Spaces are limited and demand is high and Million Moyo, Deputy Manager of the Team says ‘The problem is the logistics because we don’t have (mental health) wards on site. They need to be transferred elsewhere & where we transfer them, quite often there are no beds. It’s very unusual that there is a bed waiting for a psychiatric patient.'
Dementia can also cause great emotional distress or confusion. 75-year-old Carl’s dementia has dramatically worsened and his family take him to A&E, after he becomes aggressive at home. Patricia, his wife of 25 years, looks after him without the help of carers, but is reaching breaking point.
She says, ‘I was on the edge... breaking down - I could hardly cope -I don’t know what’s going to happen.'
Carl is admitted to the hospital’s specially designed dementia ward, developed in response to the fact that 25% of medical patients now have some form of dementia. Carl is soon medically fit to leave hospital but the hospital must secure extra support from social services before Patricia can safely take him home.
Consultant Geriatrician Colin Mitchell says ‘If you become unwell this is where you come & that is what we’d expect but there’s probably more that we’re seeing of people whose social situation has reached a breaking point. We’re just seeing more people in worse crises, as it gets more difficult to access social care or to have your problems met in the community.'
85-year-old Stanley, who also has dementia, has had 3 admissions to St Mary’s since January; this time, he was found wandering semi-naked by Police and brought to A&E.
Unpredictable and prone to outbursts of challenging behaviour, Stanley isn’t coping well at home. His family are keen for the hospital to find him a nursing home place but it won’t be easy. Not every nursing home will have the skills and resources to manage Stanley’s demanding behaviour.
His daughter Marilyn says ‘It’s sad that it takes so long because we were adding up the cost for someone like my dad to come in and out of Hospital 4 times. Wouldn’t it be great if we could cut that process down so that people could be moved more quickly to a place rather than a Hospital?"
Genre
Medicine; Business Studies; Science; Biology; Health and Social Care

How to cite this record

The Open University, "Hospital Series Two". https://learningonscreen.ac.uk/ou/search/index.php/prog/228452 (Accessed 10 Jan 2025)