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In hello, welcome to a new series of Inside Out north-west with me, Diane
Oxbridge. Tonight, bed blocking, accusing is A We look for
answers. At the moment we've got every single cubicle bar one fault.
We investigate whether our NHS is still free to everyone, wherever
they live. It matters because it leads to
inequality and health care. That's the problem. Some people get health
care for free, but others won't. And we discover how a baby rhino is
helping save the endangered species from extinction.
When they are this more life as an adventure.
They are like puppies, aren't they? Yes.
Daily life in the emergency department at Furness General
Every day we hear another warning about the crisis within the NHS. Bed
blocking, cancelled operations, queues in accident and emergency.
The system is under strain. We've had exclusive access to one of the
busiest emergency department to see exactly what pressure staff are
facing and how they are innovating to cope. Peter Marshall reports.
Daily life in the emergency department at Furness General
But we need one for that one as well.
More and more patients are coming through the doors.
It s consultant Paul Grout s job to help treat them.
As you can see at the moment we ve got every single cubicle bar one
full of patients that have come in on ambulances needing
Absolutely, the problem we have at the moment is we haven t got
anywhere for those ambulance patients to be put.
Consequently, ambulances are backing up here waiting to be able to hand
You have a paediatric cubicle as well?
Yes, which at the moment we ve actually had to put an elderly
patient in because we ve run out of suitable cubicles for them.
Just an indication of how busy it is and it s only, what,
Well, it s now gone two in the afternoon and still all
So what do patients like 73-year-old Derek Parkin,
here with respiratory problems, make of it?
They are great, they re quite attentive to be
Does he feel patients are under pressure to move out quicker?
Well, I think it s all partly a question of education.
I mean, people are coming in unnecessarily.
I mean, I was reluctant to come in because it s been on the regional
news that patients have been asked not to attend both
So I ve left it until the last minute to come in today
and I couldn t leave it any longer and I had to succumb.
Well it's now gone two in the afternoon and still all
but one of the cubicles in the emergency
There are patients still waiting for beds and the ambulance crews
who brought them to the hospital have to wait with the patients
The University Hospitals of Morecambe Bay trust which runs
Furness, also runs the emergency department at Lancaster
where they ve introduced a so called corridor nurse to tackle queues.
Is it right in a civilised society that we have
In an ideal environment what we would have is a patient
coming through the front door, being appropriately triaged and then
moved earlier to an area where they can be seen by the right
And with all the changes that we are trying to make
we would hope that in the future that is what we will be achieving.
So what are they doing to ease pressures?
To find out we go deeper into the hospital.
We currently have over half the beds with people who are medically fit
to go elsewhere either home or nursing care.
Those patients are effectively trapped in, blocking hospital beds
while waiting for a bed in a nursing or care home.
Dena Mason's one of the trust's new discharge co-ordinators brought
Social workers also now work on the ward
And the hospital has just commissioned 12
Well, hopefully if the trust have beds that we can move people
to when they are waiting for a long term bed it means it would be able
to free up some of the acute beds that are needed for people
This is Faversham House nursing home in Greater Manchester,
one of over 40 homes and two hospitals, in the Trafford area
piloting a new system to reduce delays faced when searching
We used to have a team of people who used to ring the nursing homes
on a Friday morning, they d complete a spread sheet
with the available bed information and then email it out to the teams
of people who need to know what beds are available in Trafford.
It can be out of date by the time the phone call is finished.
This new Bed State Tracker app gives real time information on what beds
It can be updated every minute of the day.
And if beds are found sooner, patients leave hospital sooner.
Should the rest of the NHS be looking at this?
There's nothing worse than somebody sat in a hospital
If they can get the right in a nursing home they should be
moved out as soon as possible and that frees up that bed.
So anything we can do to help people moving out
Back to Furness General we've been allowed in to a patient safety
meeting, now held four times a day to head off potential crises.
And a spanner is about to be thrown into the works.
Ward seven is closed. We are presently have six patients out of a
population of 33 infected with no norovirus.
The fight to clear cubicles just got tougher.
The battle to tackle the queues and free up beds won t be won
There s also a war being waged out in local communities.
The hospital trust is working with other trusts, GPs
and councils in a project called Better Care Together,
one of its aims is to treat more patients in their homes.
In Kendal, nurse Alison Nicholson helps that happen.
Today visiting the family of a former patient 95-year-old
Granddad didn't like the hospitals, didn t want to go in a home,
That's all he ever wanted was to die at home.
I can only speak on behalf of the frail and the very
old, and the evidence base for the frail and old
is that hospital isn t always the right place.
It s full of germs, unfortunately, it s full of opportunities to slip
over, and we know that older people really de-condition in a matter
of days from being in hospital, so the bigger picture for us
is to start planning with our community and our population
about bringing their care and services closer to home now.
With Alison co-ordinating his care Miles was able to spend the final
Without that care plan and that early intervention I think Miles
would have continued on his little journey round various hospitals.
Out patients, ambulances, but we were able to break the cycle
Another community, another innovation.
Millom, 50 minutes from Furness General is piloting Tele-health,
a direct video link to the emergency department at Furness General.
It s helped cut emergency admissions to the hospital from Millom
From being one of the most isolated places in the whole of Cumbria this
technology stops people having to travel.
What I would like to see very soon is that if you are waiting
for a diagnosis, a serious diagnosis like cancer, is that you don t
have to travel somewhere like Manchester or Newcastle,
that you can come into the surgery, you can ink up to Tele-health
with your doctor to that consultant and the you can sort out a care plan
and that to me is just a fantastic idea for our future.
Two years ago local residents here had to fight to save their local
health services now they are equal partners with the NHS
Education is a key part of their work.
We all know that the NHS is under pressure, we see it
on the news every day, we see it in the newspapers.
When resources are limited you have to be more careful
You have to use them appropriately and get the best value for money.
And we have a bit of a slogan, think before you act.
Just take a couple of seconds to think do I really need to access
that service or do I need to think about using another service.
The NHS will change over the next few years.
On the front line, theyll do what they've always done, offer
What would you say to those who say the answer is more beds?
The answer isn't more beds in hospitals.
The answer is looking at ways of getting patients
back to their own home with appropriate support.
One of the problems of keeping people in any institution
is when you do that you reduce their ability to look
If you keep people at home, you can keep them at home
with much smaller inputs into their health care needs.
It s better for everyone including the health economy.
As we've seen NHS budgets are tightening. Patient numbers are
rocketing. This adds pressure to Russia and treatment. So, is the NHS
still a National Service? Does where you live matter more than ever when
it comes to clear an offer? -- rationed treatment. The NHS is
affecting the most significant financial challenge in its history.
There are fears the service we've grown up with is beginning to
fragment. It's not a National Service. It's criminal. Absolutely
criminal. This is going to get worse. On a bad day it ruins your
life,. It feels like my bones are screaming at times. 33-year-old Ben
has hepatitis C. A virus that caused life-threatening liver damage. --
can cause. I'm about to my job. I've been off sick. And I could possibly
lose the flat. There are drugs that could queue the hepatitis, but they
are expensive and rationed. Then has been denied them.
All I got was, wait, basically, because my liver wasn't bad enough.
And that made me want to go out and just get absolutely wasted, Andrew
with my liver. Just so that they would treat me. I wouldn't do that,
but it wouldn't surprise me if but it wouldn't surprise me if
anyone else wouldn't. The money is there for 10,000 treatments. Each
area has a target to meet. It is claimed that means there are no
queues in parts of the North and long waits in London. To people with
exactly the same state of limit damage could present themselves in
different parts of the country. In one they can walk and get hepatitis
treatment immediately, and get skewered. In another part of the
country they may go there and be told, I'm sorry, you have to wait.
NHS England told us it regularly reallocated and used treatments to
places with waiting lists. But the number of patients treated will
increase by 25% next year. So Ben is taking the risk of treating himself
with cheaper copies of the new drugs. How much have you spent on a
box? ?1300. ?1300. But I don't really have. The fact that I've had
to pay for my treatment, it's criminal. It is absolutely criminal.
Clinical commissioning groups all CCG 's control has budgets. It's
claimed some are delaying treatment is like cataract surgeries by
slowing down referrals. Others require patients to lose weight
before getting operations like hip replacements. This bowling an
operation in these circumstances can save money in the short term. And
while these CCG 's fate can be clinically justified the Royal
College of surgeons say it can't. There is very good evidence that
people are now not getting elective operations which they desperately,
sometimes, require, simply because of the financial restriction. It is
up to the commission is to decide who should have what treatment. And
therefore, a bureaucratic system, which produces a blanket wrapped, we
think it is morally wrong. It's claimed that new systems for vetting
appointments are another form of rationing. Why are they treating
their patients with such contempt? Last month MPs complained about a
private company being paid ?10 for every GP referral they stopped. This
is rationing by the back door and has the potential to compromise
patient safety. The same private company overseas referrals in
Tyneside. We spoke to doctors who say the system is putting patients
at risk. The GPs who there speaking out her told us that cancer
diagnoses are being held up. I tried to get a patient referred to a
dermatologist. The Management service said it was a skin lesion
and rejected it. That was a disaster. It was a nasty embraces
skin cancer. The system's dangerous. They are putting up barriers. They
are using delaying tactics. It's getting between the doctor and the
specialist. In a statement North Tyneside CCG said there was no
evidence the system caused additional risk will delay. Cancer
referrals to not go through the system and are made directly to
hospital. The number of referrals not bad to GPs in England has risen
to about 30% in the last two years. The details are available online.
Shortage and regional difference have always been part of the NHS.
Today the differences could get much worse. So is the NHS still a
National Service? One of our most prominent medics is clear. No, it's
not a National Service. It's now a local health service. It matters
because it leads to inequality and health care. Some people get health
care for free, others won't. Statement the Department of Health
said that far from rationing more people than ever are getting prompt
treatment. 3261 more cancer patients are being seen every day and
standards of care are improving. We asked the Health Secretary and NHS
England for interview. Both declined. The people actually paying
for NHS services, the clinical commissioners, did agree to speak.
It's a National Service. With local variation based on the need of the
population. Demographically populations vary significantly from
county. It's really important that county. It's really important
we commission and respond to the we commission and respond to the
needs of our population by local basis. It's about making sure the
par three is correct. We don't want to squander money. We have limited
resources. It's important that we spend most effectively and get the
best value for our population. For those forced to take their own
action rationing appears all too real.
It s a year since a baby white rhino was born at Knowlsey Safari.
Rhinos face uncontrolled poaching for huge profits.
As a top European breeding centre it plays a vital role in keeping
I was given exclusive access behind the scenes to the calves first
I m not sure what I was expecting when I went to Knowsley safari
I d heard she weighed 7 stone at one week!
We are looking at a proud mum but you seem a bit
Yeah, she's phenomenal any rhino birth
But this girl just seems to have captured the hearts of everybody
we have actually had 11 born in the last decade.
It s fascinating when you think of a rhino you think of the size,
But for me for the first time to be this close to one you see
playfulness and elegance it s a completely different animal
Absolutely, obviously, when there this small life is just
Yes, absolutely I mean you ve seen the way that she runs around
Once that calf's born, it's her soul purpose to protect
She's so giddy, isn't she. Yes, she is just absolutely off the wall
sometimes. Rhino horn is now worth more
than gold on the black market. This makes white rhinos one
of the most hunted animals in the wild especially
in South Africa. The slaughter is fuelled
by the mistaken belief that rhino horn cures anything
from cancer to hangovers. With such huge profits,
criminal syndicates Poaching in the wild is literally
desolating these numbers we estimated just on 20,000
surviving in the wild and when you re looking
at up 1400, 1500 of these It is absolutely vital
that we try our hardest to make sure Unfortunately, with these
guys its not sport a lot Traditional medicine markets
in the far east also what we have found out now
is that there is a growing number of poachers that are taking
these for status symbol. One of the most frightening
situations that has occurred with them, is that its showing
peoples expendable wealth, you'll get people grinding it up
and putting it into drinks. Absolutely, it has no medicinal
purposes what so ever. At Knowsley there s enough space
for rhinos to live and breed She just wants a bit of sun
on her back, A bit of warm weather. A bit of warm weather a bit of sun
on her back, when the wind Then the public will
be able to see her. And for Jason, everything
is going to plan. And the calf has been named
Nom voo la which means She is, she s a star,
and she s perfect. She s been a massive
hit with the public, And how has she settled
because she was indoors This big wide world has got
to be so alien to them, Yes, absolutely, it does
take her a bit of time to get used to all the sights and sounds
and smells, moreso the sounds and smells than the actual sight
but her Mum shows her the way And it's amazing to watch
you with these truly wild animals, call them by their name and one
by one they get up by their name Yeah, we try to keep them as wild
as we possibly can in this environment but there are certain
things we need to do for them every now and again we may need
to intervene with medical care so to be on friendly
terms with the rhino And has anything
taken her by surprise? So when she came out full
of beams and energy, I think it took them more
by surprise because it was like wow, what s this,
we haven t seen one like this So she s not just an attraction
for the visitors here at Knowsley, she s actually an attraction
for the animals? Yeah, and it s all
part of what we do. And I ve just been given a rare
opportunity to meet this star It s not something the public should
try these animals are dangerous. But I m in safe hands
with Eveline de Wolfe, the Head of animal management
and her trusted team of keepers. So all the time you are
reassuring Mum we re ok, Yeah, but they have built up a very
good trust relationship They are very trustworthy,
they work very closely And I remember from last time,
they do like being touched. They are very tactile
amongst themselves as well. The next big step
is meeting her Dad. Because they are
separated, aren t they? We try to imitate what
happens in the wild. So the next big life step
for her is meeting her dad. These girls are very experienced,
the Mum has done it Nomvula is finally
meeting her father. It could be a very good introduction
or he could not be very pleasant when he comes out or the females
vice versa could not be But, touch wood, most times it
goes according to plan. All you can do is leave it up to
them. We have a couple of vehicles in places and if anything does get
out of hand when we are in a position where we can intervene and
separate them, and potentially take it from there. Roger, John, ready
when you are. We're ready. Standing by. It's time to let her out. An
orphaned bull from Africa this rhino was fined wondering by his mother's
dead body. She had been shot by poachers, and her horn removed. His
nose is right to the ground. What is he smelling? Detecting the centre of
the females. I wouldn't be surprised if when he does come out he follows
the exact route the females talk when they out. This is a smart he
hasn't come across yet. The opportunity for a calf and for a
mother to experience a ball with a young calf, it's all very much part
of that, you know, that life cycle. It's what would happen in the wild.
That's what we are trying to replicate within the captive
environment. The rhinos sees her father for the first time. Cheeky
Madame! She's not afraid of anything. That nose to nose greeting
is really, sort of, significant. It really is a way of communicating,
sort of, saying hello, really. The fact he backed away as good. Wherein
a good here. Yeah, this introduction couldn't have gone better. I'm
really so glad you're here to see it and see exactly what we can do with
these guys. That went brilliantly, mate. I'm going to drop the guys
Barcroft and safety. Over. It's predicted that deaths from poaching
these animals could soon overtake births. If the traders and stopped.
So this rhino will be cared for here before moving to a new home to
continue the breeding programme. That will be a sad day for Jason. It
is very emotional. When you have to say goodbye to one of them it really
does tail at your heartstrings a little bit. Do you love your job?
Absolutely, yes. 15 years on every day is magnificent. It really is.
I cannot understand why anyone would want to harm such a beautiful
creature. See you next week, goodbye.
Next week the Manchester illustrator who has gone from doodling large
paper to drawing Donald Trump for the New York Times. He's got a
comedic face, you know. I think I've got him.
Hello, I'm Louisa Preston with your 90 second update.
30 British tourists shot dead in Tunisia in 2015.
Today, an inquest was told that security forces
Donald Trump provokes a mixed reaction.
Downing Street welcomes the promise of a "quick and fair" trade deal.
But foreign ministers are concerned by his comments
It follows the collapse of the power-sharing Government.
Sinn Fein refused to nominate a new deputy first minister.
We ask what the future is for our NHS. We're behind the scenes in one of the region's busiest A&E departments as staff struggle to cope with rising patient numbers. And we look at the innovative new plans they have to cut the queues in our hospital corridors. And Dianne Oxberry goes behind the scenes to film the first year of an endangered baby white rhino at Knowsley Safari Park.