Doctors and health experts have condemned the “shocking” delays in moving a brain-damaged man to his new care home as further evidence of serious bed shortages in intensive care.
Malcolm Steward, 63, has spent months more than 100 miles from his wife. He cannot go to a care facility in Devon because of limited space at the nearby Torbay hospital. It does not have enough room in its intensive care unit to let Steward, who is severely ill, stay while he recovers from his journey down to the area.
Steward’s wife, Philippa, said that the situation had put a huge strain on the couple and their two sons, aged 19 and 27. “It’s outrageous,” she said. “A hospital cannot just choose who it treats.”
The Stewards’ case has emerged after weeks of troubling news for the government on NHS capacity issues. Leaked figures showed that January was the worst months for A&E delays on record. And last week, a coroner said the bed shortages in intensive care had led to the death of Mary Muldowney, who was refused surgery at three hospitals last year because of a lack of space.
Dr Mark Porter, who chairs the British Medical Association, said the “shocking” case of Malcolm Steward was further evidence that patients were “repeatedly and unfairly being let down by an overstretched system”. Porter added that delays for vulnerable patients were now the norm.
“The NHS is at breaking point and unfortunately demand is so great that in many hospitals there is simply no capacity left in the system,” he said. “When the appropriate care isn’t available in the right setting, patients can experience delays. This can affect the quality of the care they receive, and in this instance have a profound effect on the patient and their family’s experience of the NHS.”
Dr Gary Masterson, president of the Intensive Care Society, said: “It is difficult to comment on this case specifically but in general terms a delay of several months resulting purely from critical care bed shortages is clearly unacceptable.”
Steward was left brain-damaged after having a stroke while driving in 2015. The crash left him with multiple injuries and he spent more than a year in hospital – moving between Southampton and Guildford.
Last month he was moved to a rehabilitation unit in Salisbury, but in the meantime his wife moved to Devon, where the couple had planned to relocate to before the accident. She found a local home that would take him and the move was set for last November. When this failed to happen, she was told that Torquay hospital, which backs up the care home, had blocked the move.
A letter from the hospital’s chief operating officer, sent at the end of October, said: “Torbay hospital has a small unit and if we are to accept people who may need long-term care we will significantly limit our ability to meet the needs of our local population.” It added that the hospital, which is south Devon’s main one, was to open in the spring and would be willing to accept a further referral then.
It currently has a nine-bed intensive care unit, which is almost 30 years old. The hospital has said that when the new unit opens in the spring it will add one new bed and then a further four over the next two years.
The hospital is concerned Malcolm Steward may need long-term care in one of their private rooms because of the complexity of his needs, limiting their ability to serve the local population. Doctors, however, said having long-stay patients was not unusual.
Philippa Steward travels four hours once a week to see her husband, which she says is affecting her health. After his accident she does not like driving at night but has no other option.
“I get no sleep because I am so worried about him,” she said. “If Torbay hospital don’t change their mind soon I fear I will lose my care home bed in Devon. There’s only one space available, which they may have to give to someone else. Another one might not come up in Malcolm’s lifetime.”
While her husband is unable to talk, he knows that she is there during these visits, she said. “He smiles and holds his hand out to me when I visit. He tries to give me a hug. He writes messages to me saying, ‘I want to come home and be with you.’”
Kevin Foster, the Conservative MP for Torbay, agreed the case had taken too long to resolve. “Although the case is with the [health service] ombudsman, I am still seeking a meeting with our local NHS to work out a quicker way to bring this matter to a satisfactory conclusion, which means bringing Malcolm nearer to his family here in the bay,” he said.
A spokesman for Torbay and South Devon NHS foundation trust said it could not comment on individual patients, but that its top priority in accepting a patient from another hospital “would be to ensure that we are able to put in place a safe pathway of care appropriate to that individual patient’s clinical needs”.
The spokesman added: “We regularly liaise with [the care home] Douglas House to ensure that any patient being transferred there has plans in place to ensure their safe care and treatment. We would never refuse a patient treatment in an emergency.”
The Stewards’ case will add further pressure on the government to address NHS bed shortages. In January Hull and East Yorkshire Hospitals NHS trust ran out of intensive care beds at its two hospitals and was struggling to provide normal care to the many patients needing treatment for life threatening conditions. Senior doctors told the Guardian that intensive care units were becoming so full that patient safety was increasingly at risk because life-saving operations were having to be delayed.
The BMA’s Mark Porter said: “We urgently need the government to look at the long-term funding, capacity and recruitment issues facing the system as a whole if we are to get to grips with the extreme pressure hospitals are now facing.”
Doctors condemn delay in brain-damage man"s move to care home
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