AS an employee at the Royal Bolton Hospital, I would like to address some of the issues raised recently over waiting lists and cancelled operations.

On a surgical ward of 25 beds, at any given time at least five of those beds will be taken up by patients who require medical not surgical care. These patients cannot be transferred as no medical beds will be available. Consequently five "list" cases are denied a bed. On top of these beds, there will be a further three to four beds occupied by patients who have received surgical care but now need rehabilitation -- in order to receive this, their name is added to a waiting list to be transferred to a rehabilitation ward. Unfortunately patients often have to wait above two weeks for a bed to become available, all the while a steady stream of "list" surgical cases have to be cancelled.

As a bed does come available, very often it is taken by an emergency admission either through A & E or via GP surgeries. On many occasions these GP admissions are discharged when blood tests, scans and examinations reveal the only thing wrong with them is "holiday tummy", over-indulgence in alcohol or food poisoning. It can sometimes take hours to discharge these patients as they are that "ill" they feel the need to go walkabout, so when the doctor arrives to see them they are nowhere near their emergency bed, so discharge is delayed until their doctor can return from seeing other patients around the hospital. Consequently "list" cases cannot be admitted as their beds are being "misused".

Another common reason for beds being blocked is the social factor e.g. relatives unable to collect patients from hospital, staff unable to contact families of patients, social services not yet set up for new clients as this can sometimes take a few days to ensure a patient is provided with good quality, appropriate care at home, especially for the elderly. Unfortunately, we are a hospital with too many demands, too few resources and people queuing up to abuse the system. All the while the people on the waiting list have to keep on waiting.

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