The NHS saved Mum - but I saw a system on life support

A week ago the NHS saved my mum’s life. She had been prescribed some new blood pressure medication which caused her sodium levels to plummet dangerously. Clinicians in A&E ran blood tests, identified the problem and treated it, restoring the balance of minerals so that her sodium was once again coexisting in harmony with her potassium and the various other things floating around in the blood that we take for granted until something goes wrong with them. The staff were, without exception, kind, competent and respectful.

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So what’s the problem? My mum is the perfect case study for just how good the NHS is at saving lives and looking after older people. But the bits in between, the cement that glues the bricks, is crumbling into dust. And like the climate crisis this erosion is speeding up with disastrous consequences.

Older people are a huge cost for the NHS. Many are living longer and suffering from more chronic and complex conditions. It costs five times as much in NHS funding to care for the average 85-year-old as for the average 30-year-old.

Although Boris Johnson has pledged £1.8bn to improve 20 hospitals, and the government last year announced a £20.5bn increase in health spending by 2023/4 (a 3.4% increase), health experts say there’s not enough long-term investment to address the fundamental challenges facing the NHS. A report from the National Audit Office in January expressed concern that benefits of having the extra funding might not be realised because of difficulties in recruiting sufficient NHS staff. Analysis from the Nuffield Trust health thinktank has found that one in 12 posts are vacant in hospital and community services.

NHS hospital treatment is a conveyor belt but it has become a sclerotic one that lurches and hiccups from admission to discharge. Advances in medical science appear to inhabit a parallel universe to the process of moving through the hospital system. Too many sick people are forced to wait too many hours on trolleys before being admitted to wards because there are not enough beds available. After a bumper trolley wait in A&E and a week on an acute medical ward, my mum’s condition improved to the point where she was declared clinically fit for discharge. But instead of being swiftly escorted off the premises she became a bed blocker at the other end of the conveyor belt.

No social services assessment had been carried out to identify her post-discharge support needs. This was because hospital social workers were run off their feet with too many referrals.

“It might be a few days before a social worker can assess your mum,” said a member of staff on the ward.

“So even though she’s medically fit to leave she might ‘waste’ an acute medical bed for a few more days until the social worker has time to assess her?” I asked.

“Yes.”

“And what about all the much sicker people lying on trolleys in A&E at the start of that conveyor belt? They are being deprived of a bed they desperately need?”

“Yes.”

“And the longer vulnerable people stay in hospital the more chance there is of them picking up a nasty infection. If that happens more resources will go into treating an avoidable condition.”

“Yes.”

Fortunately my sister and I were able to pay for respite care, and hastily found some ourselves; but we had a 4.30pm deadline to get Mum there. The hospital discharge process was slow because the social work assessment hadn’t been carried out. Mum also needed a wheelchair to physically remove her from the premises.

“Where can I find a wheelchair?” I asked. I had visions of whizzing her down the polished corridors in an exhilarating sprint to meet that 4.30pm deadline.

“Wheelchair? We don’t have any.”

“But this is a hospital.”

“They’re like gold dust and they go missing.”

A helpful pharmacist whispered in my ear. “Speak to the porters at the front desk, they sometimes hide one in the cupboard.”

There were no porters there. I raced down the corridors, checking my watch, flagging down every porter I saw.

“Have you seen a wheelchair anywhere?”

“Wheelchair? Sorry love. None available, no idea where you might find one.”

In the end, staff got my mum to an exit that didn’t involve walking a mile of corridors; and the discharge mission was accomplished. A sick but improving person without relatives to advocate for them would probably have just spent a few more days in hospital.

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The business of saving lives doesn’t happen in a vacuum. NHS hospitals will be fatally compromised if the rest of the service isn’t functioning properly. Real and thoughtful investment in the health service and its poor relation, social care, is vital, such as a National Care Service to restore all the bits that have fallen away. It’s likely that increased taxes or a larger portion of our taxes will be required to fund this. The need to do so has never been more urgent. Yes, the NHS saved my mum’s life and I will never be able to thank the clinicians who did that enough. But the tipping point is imminent – too many components are rusting and dropping off the NHS engine, making it more difficult to carry out the core work.

• Diane Taylor is a freelance writer specialising in social issues