It sits, brooding, in the middle of the park.
If it could speak it’d say, ‘look at me’.
Enormous girth, dappled bark and leaves the size of dinner plates. It’s one of the best examples of the London Plane Tree I have seen.
London’s full of them because of their resistance to pollution. Streets are lined with them, parks populated with them. The Mall, Berkeley Square and the Embankment.
They might reach 100ft tall, with a 70ft canopy and can live for 200yrs.
Stout as a trencherman, our local specimen provides the shade for picnics in the summer. In autumn it dumps knee-high piles of technicolour leaves.
Right now it’s saying, winter’s on the way. The edges of its great green leaves starting to whisper, yellow. Before you know it, it’ll turn into a riot of orange and purple and rust.
Winter’s on the way. By all accounts, it’ll be a bad-un.
Early forecasts suggest a complex and dramatic season heavily influenced by a developing La Niña… the cooler counterpart of El Niño.
During a La Niña, cooler-than-average sea surface temperatures in the Pacific Ocean alter atmospheric circulation, bringing colder and wetter conditions to various regions, including Europe…
… that means us and that means colder than average temperatures, snow and ice.
For reasons of meteorological complexity (more here), the presence of a weaker-than-normal Polar Vortex (a large area of low pressure and cold air surrounding the Earth’s poles) could make things worse.
When it weakens, cold Arctic air spills south, and the role of the Quasi-Biennial Oscillation (a shifting wind pattern in the stratosphere), can interact to provide ‘disruptive weather’.
The message is, dig out yer wooly-drawers.
There’s also a message for the NHS. Whatever you are preparing for, it won’t be enough. We are in for a big freeze.
Our present winter planning is based on making what we do and have, slicker. How we work silkier, and our pathways smoother.
More money, if there is to be any, comes too late to be invested and spent wisely. It will be thrown at the problem. Sparking a forest-fire of system-cost-inflation.
Add to that, Labour still hasn’t a clue, or a plan, or an idea, what to do to fix waiting lists…
… that have hardly changed since the beginning of the year and it’s probably safe to assume that approximately 30,000 to 50,000 new patients are added to lists each month.
The waits will get longer.
I can paint a scenario where elective beds are choc-full of medical patients, waiting for social care (about which Labour appears not to care), to arrange a safe-landing home.
Waiting lists will easily bust eight million.
All the signs are this is going to be the mother-of-all-winters. If anyone at the DH+ says they are ready, they are a fool or a liar.
There’s no way the NHS is able to surge capacity because it’s already at capacity.
Hospitals are already declaring ‘major incidents’, code for; we are stuffed-to-the-gunnels… don’t come here.
It’s too late to recruit, it’s too late for money to make a difference and it’s too stupid to think sending yer granny home with an iPad, will fix anything.
It’s also far too late to fix our diminishing community services that have shrunk by 50% since 2009. Last year there were only 3,749 community nurses across the whole of the NHS… there are 5,000 lollipop ladies and gentlemen. All doing a great job, of course, but just-sayin‘.
What to do?
There isn’t a solution but there is a clue. A pointer.
There’s an army of people we could recruit. It wouldn’t solve the whole problem but it might take some of the pressure off.
In Spain, employees can take reduced hours to care for a dependent relative. Public sector employees can also work half-time for up to one month without pay loss.
When Dad, or Mum are sent home there are often relatives who could help but can’t, because they have jobs and bills to pay.
Social-care-leave could be paid for three or four weeks, by the state, for long enough to get vulnerable people home, safe and settled, until professional domiciliary care can be arranged.
I could imagine finessing the scheme with simple training in bathing, lifting, nutrition, hydration and warning signs to watch for.
It’s not unique.
In Sweden family caregivers can take up to 100 days of leave and receive a family-care allowance. The same is true in Slovakia where family members who provide informal care, can claim a care allowance.
I know, not everyone has family and all the rest of the arguments. I get that, but…
… we are very likely to be swamped this winter. Right now, well before winter, because of a lack of available care workers and placements in care homes, on average well over 10,000 frail, elderly people are stuck in hospital.
That could be the equivalent of 20 district general hospitals full of abandoned patients.
Add to that, an estimated 2 million older people in England facing challenges accessing adequate social care. Expect a huge number of them, come the bad weather, to be stuck in ambulances waiting to get into A&E.
Each degree drop below 5°C can lead to an increase of approximately 10,000 extra hospital admissions across England.
There’s nothing jaw-dropping-new in our planning, nothing novel in a response that’s based on ‘this is what we always do, with knobs on’… how can there be..
… there is no silver bullet to fix this… but some sort of caregivers allowance might be part of silver buckshot.
Come the deep midwinter…
… we might wish we’d given it a go.
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
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