- Pressure to not admit people – fair enough – but can be overdone and mean people are not admitted who should be
- Bad experience esp for elderly frail in hospital, especially A&E, so they wont go back even if that seems the best course for them
- Lack of capacity in emergency social care – so people have to be admitted as there is no where else for them to go
- Lack of community social care so people end up stuck in (sometimes dying in) hospital when they would rather be out
- Slow response of social care from council so that realistically most of our referrals for social care are emergency ones
- Ambulance service overwhelm so that sometimes people wait for hours on the floor or even with chest pain and we get called to cover 999 calls they can’t get to
- Housing crisis- I dictate 1-2 letters a day re people’s problems
- Stress and anxiety caused by benefits reviews and assessments. We don’t have a great deal of input strangely now into the original benefit application forms so we tend to only see the fall out eg the distress in anticipation or after the assessment
- The common finding that at review benefits assessments are reviewed in favour of the claimant but financial issues common whilst in the process of assessment
- Consequent low morale in the medical ( and other associated professions ) associated with the sense of failure to deliver adequate care when resources do not permit ,but where provision of adequate care is seen as a personal / practice responsibility
- Increasing complexity ( age new treatments etc ) and increasing cohorts with multiple morbidity / age – but no increasing resource to adequately serve that need
- Short sighted cost cutting choices – eg health visitor numbers district nurse numbers GP numbers – all below full complements –tendency for the loudest voices to be heard and consequent further entrenchment of the “ inverse care law”
- Removal / scarce resources for independent housing/benefits advice – bht are good. CAB now very hard to get appointments – but my experience is successful benefits appeals need you to be very switched on or have support from an organisation with experience of what “ boxes to tick”
First published by the War on Welfare blog