‘Your mother is a bed blocker’ - what happened when my Mum was discharged too soon from the Norfolk and Norwich Hospital

Around 12pc of patients who leave the Norfolk and Norwich University Hospital are readmitted within seven days. Picture: Jeremy Durkin (Image: Archant)

Less than 24 hours after the nurse in charge of discharges from a ward at the Norfolk and Norwich University Hospital said these words to me, my mother – in her late 70s - was back at home, about to suffer her second 'failed' discharge in five weeks.

I had begged the discharge team not to send my Mum home in the middle of a particularly cold snap: her heating was broken, she couldn't walk unaided, she was still using a catheter, was delirious and drifting in and out of sleep.

I was given less than a day to organise an appropriate new bed, to attempt to fill her bedroom with enough portable heaters to raise the temperature to 21C (we managed 17C with four heaters) and to bring home the equipment suggested by the occupational therapy team.

I raised concerns that the discharge team were asking someone who was delirious what they thought their care needs were and that in my opinion, she needed more care than she had asked for, which at that stage was only one visit a day.

'If we think that you have coerced your mother into asking for more care than she is entitled to, it will not be given,' I was told.

I stated yet again that I thought she would be better served by a stint in a community hospital, I pointed out how disastrous her first discharge, five weeks earlier, had been.

That ended within 16 hours when her GP visited and immediately dialled 999: she had numerous pulmonary embolisms and a severe infection.

Her second discharge lasted roughly the same amount of time.

She passed out as the hospital transport team lifted her into a wheelchair and a paramedic told me that had I not been at her home to greet her, he'd have turned round and taken her straight back to hospital.

'Keep an eye on her,' he said, 'she's just not ready to be home. We call these 'black Fridays' when the wards discharge on a Friday night.'

After relentless barracking, a package of care had finally been arranged for my Mum: three visits a day to help with personal care and feeding – the first visit was an hour after she arrived home and the carer quickly realised that my Mum's care needs hadn't been sufficiently explained to her team by the hospital.

After a proper assessment and a swift phone call, she put the record straight: her team hadn't been told my Mum was on a catheter, that she couldn't even raise herself in bed, that she needed to have her medication given to her and that she was on morphine.

Our writer was told her mother was bed blocking. Photo: Peter Byrne/PA Wire.

At this point, my Mum couldn't even remember my name (or her own), let alone how much morphine she was supposed to take. It was, the carer agreed with me, incredibly dangerous. I left Mum at 11pm and came back at 3am.

She was comfortable and warm – I had hidden the morphine – so I went home for a couple of hours of sleep.

As I drove back to her house at just before 8am, I had a call from Mum's number: the morning carer had found my Mum on the floor, hypothermic and confused. She had tried to get up to go to the toilet, forgetting the catheter, and had fallen – an ambulance was en route and she was taken back to A&E.

She had another serious infection, was delirious, dehydrated and in pain: everything I had been so frightened about, and had tried to avoid, had happened.

My Mum would go on to spend more than three months in hospital, including time at a rehabilitation unit, before she was safely discharged home.

My Mum experienced some incredibly impressive care while ill: in particular from the paramedics at the East of England Ambulance Service, in the Accident and Emergency department and in the Acute Medical Unit.

But she also experienced some shocking failures in care that I feel not only prolonged her overall stay in hospital but seriously compromised her physical health and mental wellbeing.

•Back in hospital

More than one in ten patients who leave the N&N are readmitted within a week.

Last year, 1,522 returned within a day, a readmission rate of 1.7pc.

At the Queen Elizabeth Hospital in King's Lynn, the seven-day readmission rate was 4pc compared to almost 12pc at the N&N.

A spokesperson for the N&N said: 'Our seven-day readmission rate is comparable with other trusts in England and we compare favourably against others on the 28-day readmission rate, the measure by which hospitals compare themselves nationally.

'Against a 6pc target, our 28-day readmission rate has steadily fallen and in December was 4.18pc.

'Hospital readmissions increase with age and are higher in people aged over 75 as a result of the often complex health needs, increased frailty and long-term health conditions of the patient.

'The ageing population in Norfolk is reflected in the size of our older people's admission numbers, which is significantly higher than the national average. As a result we have seen an increase in complex discharges to other healthcare and social care providers.

'For this reason, some emergency readmissions are to be expected given the complex nature of the patients treated by the Trust. It is also not always possible to be sure how a patient's condition will change once they leave hospital. It can also be the case that readmission can be related to issues in the primary care setting.

'Our Trust only discharges patients who are deemed medically fit to leave hospital and we have a discharge team who work with all partners to ensure a smooth and robust transfer from our care.

'We offer a Settle-in Service where volunteers assist patients on their day of discharge by meeting them as they return home – a time which we know can be quite difficult for some patients.

'They can also arrange for patients to be helped or referred to other services where necessary including the Red Cross Support at Home service which can offer on-going support for discharged patients.'

•Do you have a story which needs investigating? Email tom.bristow@archant.co.uk